Clinical aspects in celiac disease

Abstract

Purpose and objectives: Celiac disease or gluten sensitive-enteropathy is a systemic disease with multiple manifestations. The aim of this study was to o determine the most important clinical aspects in patients with severe celiac disease (MARSH III). Material and methods: We conducted a retrospective study on a series of consecutive patients who underwent upper gastrointestinal endoscopy between 01.01.2009-31.12.2013 in Endoscopy Unit of Targu Mures County Clinical Emergency Hospital. We included newly diagnosed patients with celiac disease with histologic confirmation. At least two bioptic samples were obtained from the distal duodenum, which were submitted to histopathological examination and scored according to MARSH criteria in 3 degrees. We included in our study only patients with duodenal atrophy (MARSH III). Results: During the studied period a number of 32 cases of celiac disease were histologically confirmed. We found a strong predominance of female, 28 cases (87.5%), with a female/male ratio of 7/1. The mean age at diagnosis was 39 years. Anemia was present in 18 patients (56.35%) with hipochromia in 14 cases (77.77%), and normochromia in 2 cases (11.11%). Other laboratory finding was elevated transaminases in 9 patients (20%) and diarrhea syndrome in 13 patients (40.62 %). Diabetes mellitus was present in 3 (9.37%) patients. Conclusions: Our data showed a low prevalence of celiac disease with histologically confirmation, but the list of those who could possibly have celiac disease can be extensive. Celiac disease is associated with a number of other medical conditions, many of which are autoimmune disorders: diabetes mellitus, but also with anemia syndromes with iron deficiency.