title: Adult celiac disease in northern India.
abstract: 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.
authors.affiliation: Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab. ajitsood10@sify.com
authors.forename: Ajit
authors.initials: A
authors.lastname: Sood
authors.forename: Vandana
authors.initials: V
authors.lastname: Midha
authors.forename: Neena
authors.initials: N
authors.lastname: Sood
authors.forename: Vineeta
authors.initials: V
authors.lastname: Malhotra
mesh_terms: 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