Frequency of celiac disease in Egyptian patients with chronic diarrhea: Endoscopic, histopathologic and immunologic evaluation

Abstract

Chronic diarrhea is one of the major presenting features of celiac disease (CD), the frequency of CD in patients with chronic diarrhea in Egypt remains unknown. The aim of this study is to determine the frequency of CD among Egyptian patients with chronic diarrhea. This study included 113 adult patients with chronic non-bloody diarrhea that attended the Tropical Medicine and Gastroenterology Department, Assiut University Hospital. All patients were subjected to full history taking, clinical examination, blood picture, serum urea and creatinine, blood glucose, liver function tests, thyroid function test, serum K, Ca and Na, anti-gliadin antibodies (AGA) IgA and IgG and tissue transglutaminase antibody IgA (anti-tTG IgA), abdominal ultrasonography, oesphagogastroduodenoscopy and duodenal biobsy for histopathology and colonoscopy. Sixteen (14.2%) out of 113 adult patients with chronic non-bloody diarrhea was diagnosed CD (positive IgA anti-tTG, histpathology and response to gluten free diet). Endoscopic findings suggesting CD were in 12 patients (75%). All diagnosed CD patients had small intestinal pathological changes of different grades according to modified Marsh classification. CD is one of the relatively frequent causes of chronic non –bloody diarrhea in Egyptian patients. Testing for CD should be indicated in those patients. Key words: Chronic diarrhea, celiac disease, tissue transglutaminase.