Prevalence of inflammatory bowel disease among coeliac disease patients in a Hungarian coeliac centre.
BACKGROUND
Celiac disease, Crohn disease and ulcerative colitis are inflammatory disorders of the gastrointestinal tract with some common genetic, immunological and environmental factors involved in their pathogenesis. Several research shown that patients with celiac disease have increased risk of developing inflammatory bowel disease when compared with that of the general population. The aim of this study is to determine the prevalence of inflammatory bowel disease in our celiac patient cohort over a 15-year-long study period.


METHODS
To diagnose celiac disease, serological tests were used, and duodenal biopsy samples were taken to determine the degree of mucosal injury. To set up the diagnosis of inflammatory bowel disease, clinical parameters, imaging techniques, colonoscopy histology were applied. DEXA for measuring bone mineral density was performed on every patient.


RESULTS
In our material, 8/245 (3,2 %) coeliac disease patients presented inflammatory bowel disease (four males, mean age 37, range 22-67), 6/8 Crohn's disease, and 2/8 ulcerative colitis. In 7/8 patients the diagnosis of coeliac disease was made first and inflammatory bowel disease was identified during follow-up. The average time period during the set-up of the two diagnosis was 10,7 years. Coeliac disease serology was positive in all cases. The distribution of histology results according to Marsh classification: 1/8 M1, 2/8 M2, 3/8 M3a, 2/8 M3b. The distribution according to the Montreal classification: 4/6 Crohn's disease patients are B1, 2/6 Crohn's disease patients are B2, 2/2 ulcerative colitis patients are S2. Normal bone mineral density was detected in 2/8 case, osteopenia in 4/8 and osteoporosis in 2/8 patients.


CONCLUSIONS
Within our cohort of patients with coeliac disease, inflammatory bowel disease was significantly more common (3,2 %) than in the general population.
2nd Department of Medicine, Semmelweis University, Szentkirályi st. 46., 1088, Budapest, Hungary. kocsisdorottya1@gmail.com.
Dorottya
D
Kocsis
Peterfy S. u. Hospital, Gastroenterology Unit, Péterfy S. st. 8-20., 1076, Budapest, Hungary. toth.zsuzsanna88@gmail.com.
Zsuzsanna
Z
Tóth
2nd Department of Medicine, Semmelweis University, Szentkirályi st. 46., 1088, Budapest, Hungary. csontosagnesanna@gmail.com.
Ágnes A
ÁA
Csontos
2nd Department of Medicine, Semmelweis University, Szentkirályi st. 46., 1088, Budapest, Hungary. pmiheller@gmail.com.
Pál
P
Miheller
Vaszary Kolos. Hospital, Gastroenterology Unit, Petőfi S. st. 26-28., 2500, Esztergom, Hungary. pakpet@t-online.hu.
Péter
P
Pák
2nd Department of Medicine, Semmelweis University, Szentkirályi st. 46., 1088, Budapest, Hungary. herszenyi.laszlo@gmail.com.
László
L
Herszényi
2nd Department of Medicine, Semmelweis University, Szentkirályi st. 46., 1088, Budapest, Hungary. totmik@gmail.com.
Miklós
M
Tóth
2nd Department of Medicine, Semmelweis University, Szentkirályi st. 46., 1088, Budapest, Hungary. tulassay.zsolt@med.semmelweis-univ.hu.
Zsolt
Z
Tulassay
2nd Department of Medicine, Semmelweis University, Szentkirályi st. 46., 1088, Budapest, Hungary. juhaszmarkdr@gmail.com.
Márk
M
Juhász
D000328:Adult; D000368:Aged; D015519:Bone Density; D002446:Celiac Disease / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D003424:Crohn Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012698:Serologic Tests; D055815:Young Adult