Assessing the prevalence of coeliac disease in patients with intellectual disabilities

Abstract

Previous studies have suggested a high prevalence of coeliac disease in patients with intellectual disabilities (Nisihara et al, 2005; Shamaly et al, 2007). To further explore any possible relationship, 196 patients with intellectual disabilities were identified in rehabilitation centres in the province of East Azerbaijan in Iran. They were matched with 196 healthy controls and screened for coeliac disease. Anti-tissue transglutaminase IgA antibodies (tTGA) and total serum IgA levels were measured, and the Marsh-Rostami criteria used to evaluate histological findings. Two patients (1%) were positive for tTG and duodenal biopsies showed Marsh I in one patient and Marsh 0 in the other. IgA deficiency was detected in three patients in the study group and tTGA was positive in one individual. Biopsies from this patient showed Marsh IIIc. From the control group only one individual had positive tTGA and five cases were IgA deficient. Two of these patients had positive tTG but both had normal histology. Coeliac disease was not found to be more prevalent in patients with intellectual disorders which suggests that screening for coeliac disease in these patients would not be cost effective.