Gastrointestinal and non-gastrointestinal presentation in patients with celiac disease.
BACKGROUND
Celiac disease (CD) may have a variety of different presentations. This study has aimed to explore the prevalence of gastrointestinal (GI) and non-GI symptoms in patients with CD according to data collected in Italy and Romania (Europe) and Iran (Middle East).


METHODS
This is a retrospective cross-sectional study conducted in Iran, Romania and Italy with data collection during the period from May 2009 - May 2011. For each center we included only patients with CD that was confirmed by endoscopy, small bowel biopsies and positive serology. GI symptoms such as abdominal pain, diarrhea, constipation, nausea and vomiting, weight loss and flatulence, as well as additional signs and symptoms of iron deficiency anemia (IDA), osteoporosis, hypertransaminasemia, and other related abnormalities were collected.


RESULTS
Overall, 323 women and 127 men, whose mean age at diagnosis was 34.2 ± 16.47 years were included in this study. Of these, 157 subjects (34.9%) reported at least one GI symptom. The majority of cases had the following primary presenting GI symptoms: diarrhea (13.6%), dyspepsia and constipation (4.0%). Other disease symptoms were reported by 168 (37.3%) patients. The most presenting non-GI symptoms in the majority of cases were anemia (20.7%) and osteopenia (6%). There were statistically significant differences between the majority of symptoms when we compared the reported clinical symptoms from different countries.


CONCLUSIONS
This study indicated that upper abdominal disorders such as abdominal pain and dyspepsia were the most common primary complaints among European patients, whereas Iranian patients had complaints of diarrhea and bloating as the classic presentations of CD. For non-GI symptoms, anemia was the most frequent complaint for both Iranian and Italian patients; however it was significantly higher in Iranians.
Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mohammad Javad
MJ
Ehsani-Ardakani
Mohammad
M
Rostami Nejad
Vincenzo
V
Villanacci
Umberto
U
Volta
Stefania
S
Manenti
Giacomo
G
Caio
Paolo
P
Giovenali
Gabriel
G
Becheanu
Mircea
M
Diculescu
Salvatore
S
Pellegrino
Giuseppe
G
Magazzù
Giovanni
G
Casella
Camillo
C
Di Bella
Nicola
N
Decarli
Mauro
M
Biancalani
Gabrio
G
Bassotti
Sabine
S
Hogg-Kollars
Mohammad Reza
MR
Zali
Kamran
K
Rostami
D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000209:etiology; D003967:Diarrhea / Q000209:etiology; D004415:Dyspepsia / Q000209:etiology; D005260:Female; D005414:Flatulence / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D014839:Vomiting / Q000209:etiology; D015431:Weight Loss; D055815:Young Adult