Celiac disease in Brazilian patients: associations, complications and causes of death. Forty years of clinical experience.
BACKGROUND
Celiac disease is a multisystem auto-immune disorder and may start at any age in genetically predisposed individuals.


OBJECTIVE
To identify associations, complications, and cause of death in Brazilian patients.


METHODS
One hundred and fifty-seven patients were studied: 23 adolescents and 134 adults, 79.6% females, 20.4% males, 75.8% at the time of diagnosis and 24.2% on a gluten-free diet, follow-up between 1 and 40 years. The diagnosis of celiac disease was based on histologic findings and the presence of serologic auto-antibodies markers for celiac disease. Specific tests were done according to clinical suspicion of associations. Bone mineral density was determined by dual energy x-rays in 53 patients upon diagnosis. The data regarding associations, complications, and causes of death were obtained by interviews and from the patient's charts.


RESULTS
Associations: atopy (22.3%), depression (17.2%), thyroid disorder (15.9%), dermatitis herpetiformis (11.5%), diabetes mellitus types 1 and 2 (4.5%) and tumors (4.5%).


RESULTS
Anemia and osteopenia/osteoporosis in all groups; increased number of spontaneous abortion. Four patients (4.5%) died (one from lymphoma, one with diabetes type 1, one from acute meningitis and one due to suicide).


CONCLUSIONS
This experience is similar to those described in the world literature. Celiac disease presents the same characteristics independently of the geographic region. We recommend periodic evaluations, from childhood, independent of the duration of the diet. The key is to establish an interval between evaluations.
Gastroenterology Service, Cajuru Hospital, Pontifical Catholic University of Paraná, Curitiba, PR, Brazil. loretekotze@hotmail.com
Lorete Maria da Silva
LM
Kotze
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D001938:Brazil; D002423:Cause of Death; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
D001323:Autoantibodies; D015415:Biomarkers