Frequency of Celiac Disease in Adult Patients with Typical or Atypical Malabsorption Symptoms in Isfahan, Iran

Mohammad Hassan Emami,Abdolmahdi Baghaei,Soheila Kouhestani,Nahid Jamali,Ali Gholamrezaei,Somayeh Karimi,Mohsen Janghorbani

doi:10.1155/2012/106965

Mohammad Hassan Emami, Abdolmahdi Baghaei + Show 5 more

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https://doi.org/10.1155/2012/106965

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Abstract

Aim. Atypical presentations of celiac disease (CD) have now been shown to be much more common than classical (typical) form. We evaluated the frequency of CD among adult patients with typical or atypical symptoms of CD. Materials and Methods. Patients referred to two outpatient gastroenterology clinics in Isfahan (IRAN) were categorized into those with typical or atypical symptoms of CD. IgA antitissue transglutaminase antibody was assessed and followed by duodenal biopsy. In patients for whom endoscopy was indicated (independent of the serology), duodenal biopsy was taken. Histopathological changes were assessed according to the Marsh classification. Results. During the study period, 151 and 173 patients with typical and atypical symptoms were evaluated (mean age = 32.8 ± 12.6 and 35.8 ± 14.8 years, 47.0% and 56.0% female, resp.). Frequency of CD in patients with typical and atypical symptoms was calculated, respectively, as 5.9% (9/151) and 1.25% (3/173) based on positive serology and pathology. The overall frequency was estimated as at least 9.2% (14/151) and 4.0% (7/173) when data of seronegative patients were also considered. Conclusions. CD is more frequent among patients with typical symptoms of malabsorption and these patients should undergo duodenal biopsy, irrespective of the serology. In patients with atypical symptoms, serological tests should be performed followed by endoscopic biopsy, and routine duodenal biopsy is recommended when endoscopic evaluation is indicated because of symptoms.

Highlights

Celiac Disease (CD), known as gluten-sensitive enteropathy, is a genetic disorder affecting both children and adults
In patients with atypical symptoms, serological tests should be performed followed by endoscopic biopsy, and routine duodenal biopsy is recommended when endoscopic evaluation is indicated because of symptoms
We found that celiac disease (CD) is present in about 9.2% of the patients coming with typical symptoms (12.1% (13/107) of the patients with chronic diarrhea) and 4.0% of those who come with atypical symptoms of malabsorption

Summary

Introduction

Celiac Disease (CD), known as gluten-sensitive enteropathy, is a genetic disorder affecting both children and adults. People with CD are unable to eat foods that contain gluten because, in these patients, gluten sets off an autoimmune reactions that cause the destruction of the small intestinal villi and leading to a malabsorption syndrome [1, 2]. Classical symptoms of CD in adults include chronic diarrhea, steatorrhea, and weight loss. Steatorrhea is associated with severe, extensive enteropathy, but it is often absent in patients whose disease is limited to the more proximal portions of the small intestine [2]. Classical symptoms of CD are present in less than 50% of the patients at presentation [1]. There are no drugs to treat CD and there is no cure, a gluten-free diet (GFD) can lead to a normal and healthy live

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