title: [Adult celiac disease: clinical experience].
abstract: BACKGROUND
  The prevalence of celiac disease (CD) is unknown in Chile. We have recently noted a rise in the number of cases diagnosed among adults.
  
  
  OBJECTIVE
  To describe the clinical characteristics of a group of adult celiac patients.
  
  
  METHODS
  Clinical data of patients older than 15 years with positive antitransglutaminase or antiendomysial autoantibodies and a duodenal biopsy characteristic of CD were retrospectively reviewed. Age at diagnosis, symptoms and signs and laboratory, endoscopic and histological findings, were analyzed.
  
  
  RESULTS
  Thirty seven patients (28 women), were studied. Median age at diagnosis was 41 years (range 15-69). Main symptoms and signs were diarrhea (78%), weight loss (38%) and abdominal pain (38%). Anemia was found in 49%, elevation of ESR in 57%, elevation of alkaline phosphatases in 54%, elevation of aspartate aminotransferase in 38% and a rise in alanine aminotransferase in 27%. Antiendomysial antibodies were positive in 17/22 (77%) and antitransglutaminase in 19/22 (86%) patients. Endoscopic findings were suggestive of CD in 47% of cases and duodenal biopsy showed intestinal villi atrophy in 34 (92%) patients. The three patients with normal histology had positive serology and a good response to gluten free diet.
  
  
  CONCLUSIONS
  CD should be considered in the differential diagnosis of patients with unespecific digestive symptons, even when they present late in adult life. Serologic markers are a good diagnostic tool. A normal duodenal pathology does not exclude the diagnosis, if other diagnostic features are present.
authors.affiliation: Sección de Gastroenterología, Departamento de Medicina, Hospital Clínico de la Universidad de Chile, Santiago, Chile.
authors.forename: Carla
authors.initials: C
authors.lastname: Mancilla A
authors.forename: Ana María
authors.initials: AM
authors.lastname: Madrid S
authors.forename: Jorge
authors.initials: J
authors.lastname: Valenzuela E
authors.forename: Antonio
authors.initials: A
authors.lastname: Morales B
authors.forename: Carmen
authors.initials: C
authors.lastname: Hurtado H
authors.forename: Gladys
authors.initials: G
authors.lastname: Smok S
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Ledezma R
authors.forename: Iván
authors.initials: I
authors.lastname: Castillo M
authors.forename: Mauricio
authors.initials: M
authors.lastname: Rivas Q
authors.forename: Javier
authors.initials: J
authors.lastname: Brahm B
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002446:Celiac Disease / Q000097:blood / Q000276:immunology / Q000473:pathology*; D003937:Diagnosis, Differential; D004386:Duodenum / Q000276:immunology / Q000473:pathology*; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D011503:Transglutaminases / Q000097:blood / Q000276:immunology
chemical_list: D015415:Biomarkers; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D011503:Transglutaminases