Histologic Findings in Gastric Biopsies at Diagnosis and Follow-Up in an Adult Celiac Disease Population

SUMMARY OBJECTIVE It has been observed that celiac disease (CD) is not restricted to a single type characterized by diarrhea but also has atypical, asymptomatic (silent), and latent forms. The prevalence of this autoimmune disease, which affects approximately 1% of the world, is estimated to be around 3%, including atypical and asymptomatic cases. In our study, we aimed to evaluate adult celiac patients. METHODS Between December 2008-2015, patients diagnosed with CD over the age of 18 years old were included in the study. Patients’ symptoms at admission, frequency and type of anemia, transaminase levels, and celiac antibody positivity, and autoimmune diseases diagnosed at follow up were evaluated retrospectively. RESULTS Of 195 patients, 151 (77.4%) were female. The mean age of the patients was 35.73 ± 12.19 years (range, 18-71 years). A hundred patients (51.3%) had gastrointestinal symptoms. At the time of admission, 118 patients (60.5%) had anemia, and 52 (26.7%) had hypertransaminasemia. During the mean follow-up period of 58 months (36-120 months), 84 (43.1%) of the patients presented at least one autoimmune disease, and this rate was 96.6% in individuals diagnosed above the age of 50 years. CONCLUSION In adult CD, resistant anemia, dyspepsia, and hypertransaminasemia are very common findings at the time of diagnosis, and the association with other autoimmune diseases, especially Hashimoto’s thyroiditis, is high.

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Back pain and sacroiliitis in long-standing adult celiac disease: a cross-sectional and follow-up study

Rheumatology International ◽

10.1007/s00296-009-0979-3 ◽

2009 ◽

Vol 30 (4) ◽

pp. 455-460 ◽

Cited By ~ 14

Author(s):

Edit Vereckei ◽

Ádám Mester ◽

László Hodinka ◽

Péter Temesvári ◽

Emese Kiss ◽

...

Keyword(s):

Celiac Disease ◽

Back Pain ◽

Cross Sectional ◽

Follow Up Study ◽

Adult Celiac Disease

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Clinical Spectrum of Biopsy-Defined Celiac Disease in the Elderly

Canadian Journal of Gastroenterology ◽

10.1155/1995/290893 ◽

1995 ◽

Vol 9 (1) ◽

pp. 42-46 ◽

Cited By ~ 19

Author(s):

Hugh J Freeman

Keyword(s):

Celiac Disease ◽

The Elderly ◽

Intestinal Biopsy ◽

Neoplastic Disease ◽

Small Intestinal Biopsy ◽

Adult Celiac Disease ◽

History Of ◽

Systemic Nature ◽

Definition Of

Thirty patients (17 females and 13 males) with adult celiac disease initially diagnosed after age 60 were seen during a 12-year period. Diagnosis in each patient was based on small intestinal biopsy and a clinical as well as histological response to a strict gluten-free diet. Diarrhea, weight loss and/or anemia, usually due to iron deficiency, were present in the majority of patients and often lead to other diagnostic considerations, including colon cancer, prior to definition of celiac disease. No patient in this series had a known family history of celiac disease. Dermatitis herpetiformis and thyroid hypofunction were frequently detected in this elderly population, possibly reflecting the autoimmune and systemic nature of celiac disease. Neoplastic disease was common in this age group, suggesting that particular vigilance in follow-up is required, especially for lymphoma, in elderly patients with celiac disease.

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Lack of control of adult celiac disease at long term follow-up: Indices of intestinal mucosa status

Digestive and Liver Disease ◽

10.1016/s1590-8658(00)80645-3 ◽

2000 ◽

Vol 32 ◽

pp. A117

Author(s):

C. Ciacci ◽

M. Cirillo ◽

F. Labanca ◽

G. Mazzacca

Keyword(s):

Celiac Disease ◽

Intestinal Mucosa ◽

Adult Celiac Disease ◽

Lack Of Control ◽

Long Term Follow Up

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Back pain and sacroiliitis in long-standing adult celiac disease: a cross-sectional and follow-up study

Rheumatology International ◽

10.1007/s00296-010-1375-8 ◽

2010 ◽

Vol 31 (2) ◽

pp. 279-279

Author(s):

Cumali Efe ◽

Tugrul Purnak ◽

Ersan Ozaslan ◽

Zeynep Ozbalkan

Keyword(s):

Celiac Disease ◽

Back Pain ◽

Cross Sectional ◽

Follow Up Study ◽

Adult Celiac Disease

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Rationale for Timing of Follow-Up Visits to Assess Gluten-Free Diet in Celiac Disease Patients Based on Data Mining

Nutrients ◽

10.3390/nu13020357 ◽

2021 ◽

Vol 13 (2) ◽

pp. 357

Author(s):

Alfonso Rodríguez-Herrera ◽

Joaquín Reyes-Andrade ◽

Cristina Rubio-Escudero

Keyword(s):

Data Mining ◽

Celiac Disease ◽

Cultural Context ◽

Gluten Free Diet ◽

Gluten Free ◽

Adherence To Diet ◽

And Gender ◽

Few Data

The assessment of compliance of gluten-free diet (GFD) is a keystone in the supervision of celiac disease (CD) patients. Few data are available documenting evidence-based follow-up frequency for CD patients. In this work we aim at creating a criterion for timing of clinical follow-up for CD patients using data mining. We have applied data mining to a dataset with 188 CD patients on GFD (75% of them are children below 14 years old), evaluating the presence of gluten immunogenic peptides (GIP) in stools as an adherence to diet marker. The variables considered are gender, age, years following GFD and adherence to the GFD by fecal GIP. The results identify patients on GFD for more than two years (41.5% of the patients) as more prone to poor compliance and so needing more frequent follow-up than patients with less than 2 years on GFD. This is against the usual clinical practice of following less patients on long term GFD, as they are supposed to perform better. Our results support different timing follow-up frequency taking into consideration the number of years on GFD, age and gender. Patients on long term GFD should have a more frequent monitoring as they show a higher level of gluten exposure. A gender perspective should also be considered as non-compliance is partially linked to gender in our results: Males tend to get more gluten exposure, at least in the cultural context where our study was carried out. Children tend to perform better than teenagers or adults.

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Changes in Age at Diagnosis and Nutritional Course of Celiac Disease in the Last Two Decades

Nutrients ◽

10.3390/nu12010156 ◽

2020 ◽

Vol 12 (1) ◽

pp. 156 ◽

Cited By ~ 2

Author(s):

Mónica Villanueva ◽

Amaya Oyarzún ◽

Bárbara Leyton ◽

Mónica González ◽

Elizabeth Navarro ◽

...

Keyword(s):

Celiac Disease ◽

Nutritional Status ◽

Gastrointestinal Symptoms ◽

Failure To Thrive ◽

Age At Diagnosis ◽

Pediatric Hospitals ◽

Geographical Variations ◽

Number Of Patients ◽

Antiendomysial Antibodies

The frequency of celiac disease (CD) has increased along time, with relevant changes reported in geographical variations, clinical presentation and nutritional repercussions. In recent years, some celiac patients are presenting overweight/obesity, but it is unclear how frequent this is and to what extent undernutrition remains a concern. This is relevant because CD tends to be overlooked in overweight patients. With this in mind, we assessed age at diagnosis, clinical characteristics and nutritional status of 155 celiac patients diagnosed between 1994–2017 in four pediatric hospitals in Santiago, Chile. Since 2003, the number of patients diagnosed has increased (p < 0.0033), coinciding with antitransglutaminase and antiendomysial antibodies becoming available to public health systems. In 2000, 4.5% of patients were asymptomatic at diagnosis, suggesting that active search is not routinely applied. Gastrointestinal symptoms plus failure to thrive were significantly more frequent under 2 years (p = 0.0001). Nutritional status has improved at diagnosis and during follow up, but undernutrition remains more frequent in children <2 and <5 years (p < 0.002 and p < 0.0036, respectively). Overweight at diagnosis was reported in 2002 and obesity in 2010. After initiating treatment, since 2010, patients changing from undernourishment to overweight has sometimes been observed after only 6 months on a gluten-free diet.

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