Celiac disease in Brazilian adults.
Forty-eight adult patients with celiac disease between 15 and 68 years of age (mean, 41 years) were studied. Sixty-seven percent were female and 33% were male patients. Most of the patients were white (98%). The main clinical features were diarrhea (90%), weight loss (70%), and abdominal pain (56%). On physical examination, the main findings were pallor (40%), aphthous stomatitis (31%), and arthralgia (23%). Associated disorders included diabetes mellitus type I, osteoporosis, and atopy (6% each); dermatitis herpetiformis and depression (4% each); and hypothyroidism, hyperthyroidism, duodenal carcinoma, and Gilbert syndrome (2% each). The histologic results according to Marsh criteria (modified by Rostami) are as follows: type I, 10%; type II, 21%; type IIIa, 19%; type IIIb, 17%; and type IIIc, 33%. The sensitivity and specificity for the antiendomysium antibody-immunoglobulin A test were 92% and 100%, respectively, when considering the whole group of patients; however, the sensitivity (but not the specificity) decreased to 86% when taking into account only the group of patients with mild histologic alterations (Marsh type I, II, and IIIa).


CONCLUSIONS
In general, the authors' results are similar to those described in developing countries, indicating that celiac disease might have the same spectrum of presentation regardless of the region studied.
de Freitas
Isabella Nicácio
IN
Laboratory of Medical Investigation (LIM-07), Hospital das Clínicas, School of Medicine of the University of São Paulo, São Paulo, Brazil.
Sipahi
Aytan Miranda
AM
Damião
Adérson O M C
AO
de Brito
Thales
T
Cançado
Eduardo Luiz Rachid
EL
Leser
Paulo Guilherme
PG
Laudanna
Antonio Atilio
AA
D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D002446:Celiac Disease / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D003967:Diarrhea / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015431:Weight Loss