1
|
Bari Z, Hadipour M, Fakheri H, Kazemi A, Maleki I, Taghvaei T, Hosseini V, Valizadeh SM, Masoumi D, Shahbazkhani B, Shokri Shirvani J, Tirgar Fakheri S, Ebrahimi R. Epidemiological, Endoscopic, Clinical, and Pathological Features of Patients with Celiac Diseases in Southern Littoral of Caspian Sea. Middle East J Dig Dis 2023; 15:257-262. [PMID: 38523893 PMCID: PMC10955989 DOI: 10.34172/mejdd.2023.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 07/29/2023] [Indexed: 03/26/2024] Open
Abstract
Background: Celiac disease is an autoimmune disorder resulting from gluten consumption in genetically predisposed individuals. The present study investigated the epidemiological, endoscopic, and clinicopathological features of patients with celiac disease in the southern littoral of the Caspian Sea. Methods: 140 patients with celiac disease were interviewed and examined regarding demographic characteristics, clinical symptoms, and serologic, endoscopic, and pathological findings. Results: 44 (31.4%) of the patients were male and 68.6% were female. The mean age of the patients at diagnosis was 27.13±13.4 years (ranging from 2 to 60 years). The most common gastrointestinal (GI) symptoms were bloating (47.8%), abdominal pain (47.1%) and diarrhea (30.7%), respectively. Also, 17 (12.1%) patients did not complain of any GI symptoms.18 (12.8%) patients had aphthous stomatitis, 10.7% had dermatitis herpetiformis, 3.6% suffered from itching without a rash, two (1.4%) mentioned psoriasis and one (0.7%) had lichen planus. 19 (19.7%) of the female patients complained of menstrual bleeding disorders, 4% mentioned infertility, and 2% experienced primary amenorrhea. The most common comorbid condition was hypothyroidism in 16 (11.4%) patients. The most common endoscopic finding was duodenal scalloping (37.25%). In addition, 7.8% of the patients had a normal endoscopic appearance. 43 (30.7%) patients were classified as Marsh IIIC, 25.7% Marsh IIIB, 17.8% Marsh IIIA, 12.8% Marsh II and 12.8% were classified as Marsh I. Conclusion: Since celiac disease can present with non-GI manifestations and the majority of our patients had Marsh III classification, it seems that celiac disease must be considered as a routine screening test in GI clinics, and also, it should be kept in mind as a differential diagnosis in other specialty fields.
Collapse
Affiliation(s)
- Zohreh Bari
- Department of Internal Medicine, Gut and Liver Research Center, Non-communicable Disease Research Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Hafez Fakheri
- Department of Internal Medicine, Gut and Liver Research Center, Non-communicable Disease Research Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Arash Kazemi
- Department of Internal Medicine, Gut and Liver Research Center, Non-communicable Disease Research Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iradj Maleki
- Department of Internal Medicine, Gut and Liver Research Center, Non-communicable Disease Research Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Tarang Taghvaei
- Department of Internal Medicine, Gut and Liver Research Center, Non-communicable Disease Research Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Vahid Hosseini
- Department of Internal Medicine, Gut and Liver Research Center, Non-communicable Disease Research Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Mohammad Valizadeh
- Department of Internal Medicine, Gut and Liver Research Center, Non-communicable Disease Research Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Danial Masoumi
- Student of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Bijan Shahbazkhani
- Department of Gastroenterology, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Javad Shokri Shirvani
- Department of Internal Medicine, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Sepehr Tirgar Fakheri
- Gut and Liver Research Center, Non-communicable Disease Research Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reyhaneh Ebrahimi
- Gut and Liver Research Center, Non-communicable Disease Research Institute, Mazandaran University of Medical Sciences, Sari, Iran
| |
Collapse
|
2
|
Semwal P, Gupta RK, Sharma R, Garg K. Comparison of Endoscopic and Histological Findings between Typical and Atypical Celiac Disease in Children. Pediatr Gastroenterol Hepatol Nutr 2018; 21:86-92. [PMID: 29713605 PMCID: PMC5915695 DOI: 10.5223/pghn.2018.21.2.86] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 10/07/2017] [Accepted: 12/29/2017] [Indexed: 01/27/2023] Open
Abstract
PURPOSE Celiac disease is a common non-communicable disease with varied presentations. Purpose of this study was to find the duodeno-endoscopic features in celiac disease and to compare duodeno-endoscopic and histological findings between typical and atypical celiac disease in children. METHODS Hospital based observational study was conducted at Sir Padampat Mother and Child Health Institute, Jaipur from June 2015 to May 2016. Patients were selected and divided in two groups- typical and atypical celiac disease based upon the presenting symptoms. Upper gastrointestinal endoscopy and duodenal biopsy was performed for serology positive patients. Results were analysed using appropriate statistical test of significance. RESULTS Out of 101 enrolled patients, 47.5% were male. Age ranged from 1 to 18 years. Study showed that 54.5% were typical and 45.5% were atypical. Patients presenting with atypical symptoms were predominantly of older age group. On endoscopy, scalloping, mosaic pattern, reduced fold height and absent fold height; and in histology, advanced Marsh stage were significantly higher in the typical group. CONCLUSION Awareness of atypical presentations as well as duodeno-endoscopic features may have considerable practical importance for the diagnosis of celiac disease in children. Scalloping, mosaic pattern, reduced fold height and nodularity are main endoscopic markers of celiac disease in children. Endoscopic markers of duodenal mucosa may be important in early diagnosis of celiac disease, in children subjected to endoscopy for atypical presentations or indication other than suspected celiac disease.
Collapse
Affiliation(s)
- Pooja Semwal
- Department of Paediatric Medicine, Sawai Man Singh Medical College, Jaipur, India
| | - Raj Kumar Gupta
- Department of Paediatric Medicine, Sawai Man Singh Medical College, Jaipur, India
| | - Rahul Sharma
- Department of Community Medicine, University College of Medical Sciences, Delhi, India
| | - Kapil Garg
- Department of Paediatric Medicine, Sawai Man Singh Medical College, Jaipur, India
| |
Collapse
|