[Malnutrition in adults with gastrointestinal disorders: a new reservoir of celiac disease?].
OBJECTIVE
To present the diagnostic process of CD Celiac disease among adults showing variable signs of nutritional derangements assisted at two tertiary-level health care institutions in Havana City (Cuba) between 2004 - 2007 for non-exhaustively characterized gastrointestinal disorders.


METHODS
Clinical, serological, histo-pathological and nutritional findings were integrated into an ad hoc created scoring system. Weight gain was monitored during the study observation window.


RESULTS
Twenty-eight presumptive celiac patients were identified among those assisted. CD diagnosis was as follows: Confirmed: 17.9% (Score: 9.2 +/- 0.4); Highly likely: 60.7% (Score: 6.6 +/- 1.1); Non-conclusive: 32.1% (Score: 4.7 +/- 0.5); respectively. Ninety-two point eight percent of subjects were malnourished at the moment of the first interview. Total intestinal villi atrophy was observed in less than one-third of the identified celiac patients. Tittering of antibodies associated with CD was as follows: Anti-gliadin: Completed: 25; Positive: 72.0%; Anti-transglutaminase: Completed: 11; Positive: 54.5%. Nutritional replenishment actions comprised: Diet gluten withdrawal (100.0%); Vitamins and minerals prescription (92.9%); supplementary Enteral Nutrition (57.2%); and Parenteral Nutrition (21.4%). Weight gain was of 400 grams in 80.8% of CD patients after 33.7 days of follow- up; and of 700 grams in 13 of them after 321 days. The scoring system presented in this study could be useful for diagnosis and treatment of CD: a condition that keeps baffling physicians and nutritionists alike.
Santana-Porbén
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S
Escuela de Medicina de La Habana, Facultad de Biología, Universidad de La Habana, Havana, Cuba. ssergito@infomed.sld.cu
Castellanos-Fernández
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M
D000368:Aged; D002446:Celiac Disease / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D003462:Cuba; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis*; D006801:Humans; D007422:Intestines / Q000473:pathology; D008297:Male; D044342:Malnutrition / Q000150:complications* / Q000209:etiology; D008875:Middle Aged; D009752:Nutritional Status; D018529:Nutritional Support; D015430:Weight Gain