Adult celiac disease in northern India.
OBJECTIVE
To study the presentation of adult celiac disease in a northern Indian hospital.


METHODS
Case records of all patients diagnosed as having adult celiac disease in the Gastroenterology unit of this hospital during January 1996 till December 2001 were reviewed. Celiac disease was diagnosed according to the revised ESPGAN criteria. Adult celiac disease was diagnosed if disease manifestations started after 15 years of age. All patients had a minimum of one-year follow up.


RESULTS
The mean duration of illness in the 96 patients (mean [SD] age 32.9 [11.4] years; 50 men) diagnosed over the 6-year study period was 7.3 (2.4) years. Diarrhea was present is 67.7% of cases; 18.7% presented with refractory iron-deficiency anemia, and 9.4% with abdominal symptoms like flatulence and distension. Three patients presented with dysphagia and anemia and were diagnosed as having Plummer-Vinson syndrome. Ulcerative colitis, non-alcoholic steatohepatitis, and aphthous ulcers were associated conditions. All patients had significant improvement in symptoms and hematological and biochemical parameters after dietary gluten restriction.


CONCLUSIONS
Adult celiac disease is not rare and usually presents as diarrhea, abdominal distension and flatulence, and refractory anemia.
Sood
Ajit
A
Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab. ajitsood10@sify.com
Midha
Vandana
V
Sood
Neena
N
Malhotra
Vineeta
V
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002446:Celiac Disease / Q000175:diagnosis* / Q000178:diet therapy / Q000378:metabolism; D003937:Diagnosis, Differential; D018753:Diet, Protein-Restricted; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance