Prevalence of celiac disease in patients with atypical presentations |
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| Affiliation: | 1. Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran;2. Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran;3. Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran;4. Center for Prevention and Diagnosis of Celiac Disease, Division of Gastroenterology and Endoscopy, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy;5. Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran;1. Endemic Medicine Department, Cairo University Hospitals, Cairo, Egypt;2. Kasr Al-Aini HIV and Viral Hepatitis Fighting Group, Cairo University Hospitals, Cairo, Egypt;3. Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa;4. Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Assiut University, Assiut, Egypt;5. Hepatology Department, Mustapha Bacha Hospital, University of Algiers, Algeria;6. St. Paul''s Hospital Millennium Medical College, Addis Ababa, Ethiopia;1. Microbiology and Immunology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt;2. Endemic Medicine and Hepatogastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt;3. Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt;1. Chest Department, Assiut University Hospitals, Assiut 71515, Egypt;2. Aswan Faculty of Medicine, Aswan, Egypt;3. Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt;4. Faculty of Medicine, Assiut University, Assiut 71515, Egypt;5. Internal Medicine and Surgery (adults), Faculty of Nursing, Assiut University, Egypt;6. Public Health and Community Medicine Department, Assiut Faculty of Medicine, Egypt;7. Undergraduate House Officer, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt;8. Undergraduate House Officer, Faculty of Medicine, Assiut University, Egypt;9. Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Egypt;1. Department of Internal Medicine, Gastroenterology Unit, Faculty of Medicine, AL-Azhar University, Cairo, Egypt;2. Department of Internal Medicine, Gastroenterology Unit, Faculty of Medicine, AL-Azhar University, Cairo, Egypt;3. Department of Clinical Pathology, Faculty of Medicine, AL-Azhar University, Cairo, Egypt |
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| Abstract: | Background and study aimsUnawareness about atypical forms of celiac disease (CD) leads to the underdiagnoses of CD. This study has investigated the prevalence of CD in patients with atypical presentations, such as idiopathic low bone mineral density (ILBMD) and dyspepsia, in the Iranian population.Patients and methodsTwo separate groups of patients who have been diagnosed with dyspepsia and ILBMD (including either osteopenia or osteoporosis of unknown cause) were screened for CD during 2016–2019. Patients were serologically screened by means of IgA anti-tissue transglutaminase (IgA anti-tTG); in case of positive results, the patients underwent endoscopic intestinal biopsy to confirm the diagnosis of CD.ResultsOf 200 patients with ILBMD, six (3%) had a positive result for IgA anti-tTG; in five cases (2.5%), duodenal histology confirmed the CD diagnosis. Of 290 patients with dyspepsia, 25 (8.6%) had a positive result for anti-tTG IgA; nine cases (3.7%) were histologically compatible with CD. No significant differences were found between the two groups of patients.ConclusionsThe prevalence of CD in patients with atypical presentations, such as ILBMD and dyspepsia, is consistent (pvalue = 0.788) and higher than that in the general population (p value = 0.001); therefore, screening program for CD in these patients is highly recommended. |
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| Keywords: | Celiac disease Low bone mineral density Dyspepsia IgA anti-tTG |
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