Clinical and laboratory features and extraintestinal manifestations of celiac disease in adults

Abstract

AimCeliac disease an autoimmune disorder resulting from an immune re-sponse to the gluten in genetically predisposed patients. Although, diarrhea is the most common finding at presentation in adults, disease may present with extraintestinal manifestations such as anemia, osteoporosis, elevated transaminase levels and growth retardation. In this article, symptoms, ex-traintestinal manifestations and coexistence with other autoimmune dis-orders of adult patients with celiac disease were evaluated.Methods22 patients whose followed with the diagnosis of celiac disease in Suleyman Demirel University Department of Gastroenterology, between January 2007 and Semptember 2010, were evaluated retrospectively. Symp-toms, extraintestinal manifestations and coexistence with other autoimmune disorders of patients at presentation were investigated.Results13 (59%) of all cases were female and 9 (41%) were male. Mean age at presentation was 38,5 years. Most common complaints were diarrhea and weakness . Tis-sue transglutaminase and/or antiendomysium antibody were positive, and diagnosis was confirmed by histopathologic examination in all patients. Iron deficiency, vitamine B12 deficiency and folic acid deficiency were detected in 17 (77%), 8 (36%) and 6 (27%) patients, respectively. There were elevated transaminase levels in 8 (36%) patients. Osteoporosis was detected in 4 female and 1 male patients. Sensorimotor polineuropathy was detected in 2 patients. There was growth retardation in 2 patients. Autoimmune hypo-thyroidism and Type 1 diabetes mellitus were detected in 2 and 1 patients, respectively. Coexistence with Crohn’s disease was detected in a patient.ConclusionCeliac disease may present with extraintestinal manifestations in adults. It should be remembered, especially in patients with iron deficiency and mild to moderate transaminase elevations with unexplained etiology. It should be considered in patients with chronic diarrhea and, complications such as anemia, osteoporosis and growth retardation, must be prevented.

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