title: [Diagnostic problems in adult celiac disease].
abstract: BACKGROUND
  Celiac disease (CD) is a chronic immune-mediated enteropathy, resulting from a gluten intolerance in genetically predisposed individuals.
  
  
  OBJECTIVE
  a) to describe clinical features, associated disorders and serology of CD in adults; and b) to study the main that serology displays in diagnosis, clinical and histological expression.
  
  
  METHODS
  31 patients diagnosed of CD in adulthood have been reviewed retrospectively, including clinical presentation, associated disorders, biochemical results, serological tests (anti-gliadin and anti-endomysial antibodies) and genetical features (HLA-DQ2). It has been studied the relation between typical presentations and AEm with clinical, serological or histological findings.
  
  
  RESULTS
  Almost 50% of patients had atypical clinical manifestations and gastrointestinal symptoms were absent in 33%. Typical manifestations are associated with villous atrophy stage III b-c of Marsh's classification (87 vs. 53%, p = 0,03). 70% of patients shows AEm mostly in women (78 vs. 37%, p = 0.03) and stage III b-c of Marsh (84 vs. 50%, p = 0.05). 68,4% were DQ2 positive.
  
  
  CONCLUSIONS
  Clinical features of CD varies greatly. AEm and DQ2 are less common than others studies. There may be an association with clinical and serological findings and villous atrophy stage. Genetical features could help AEm in diagnosis.
authors: Servicios de Aparato Digestivo, IBGM, Hospital Clínico Universitario de Valladoli, Universidad de Valladolid. luisfersal@wanadoo.es
authors: L I
authors: LI
authors: Fernández Salazar
authors: N
authors: N
authors: de la Torre Ferrera
authors: B
authors: B
authors: Velayos Jiménez
authors: M
authors: M
authors: Nocito Colón
authors: J M
authors: JM
authors: González Hernández
authors: J A
authors: JA
authors: Garrote Adrados
mesh_terms: D000328:Adult; D002446:Celiac Disease / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies