title: Similarities and differences between older and young adult patients with celiac disease.
abstract: OBJECTIVE
  Celiac disease is an autoimmune enteropathy with variable clinical symptoms. Elderly patients can have different manifestations from those of young patients. The aims of the present study were to investigate whether any differences or similarities exist between older and young patients with celiac disease with a special emphasis on concurrent autoimmune diseases.
  
  
  METHODS
  Celiac disease patients were stratified as older and younger patients. These two groups were then compared by means of clinical symptoms, laboratory parameters and concurrent autoimmune diseases. Factors associated with the presence of an autoimmune disease were identified by univariate and multivariate analysis.
  
  
  RESULTS
  There were 66 older patients (mean age 67.7 ± 3.2 years, 50 women), and 277 younger patients (mean age 35.9 ± 11.7 years, 207 women). Of the 66 older patients, eight patients had gastrointestinal symptoms and 58 patients had extradigestive symptoms. In the younger group, the number of patients referred due to gastrointestinal symptoms was higher (8 [12.2%] vs 200 (72.2%), P < 0.001) compared with the older group. Whereas 10 (15.1%) older patients showed polyautoimmunity, 55 (19.8%) younger patients had polyautoimmunity. Multiple autoimmune syndrome was more common in older patients compared with young patients (31 [47%] vs 12 [4%], P < 0.001, respectively).
  
  
  CONCLUSIONS
  The presentation of celiac disease clinically, histologically and by means of laboratory parameters is different in older and young patients. Polyautoimmunity and multiple autoimmune syndrome are more common in older patients compared with younger patients. A biopsy score of Marsh score type, antinuclear antibody positivity, high serum anti-tissue transglutaminase immunoglobulin A level and low hemoglobin level were risk factors for having an autoimmune disease. Geriatr Gerontol Int 2017; 17: 2060-2067.
authors.affiliation: Ankara University Faculty of Medicine, Department of Gastroenterology, Ankara, Turkey.
authors.forename: Çağdaş
authors.initials: Ç
authors.lastname: Kalkan
authors.affiliation: Ankara University Faculty of Medicine, Department of Gastroenterology, Ankara, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Karakaya
authors.affiliation: Ankara University Faculty of Medicine, Department of Gastroenterology, Ankara, Turkey.
authors.forename: Irfan
authors.initials: I
authors.lastname: Soykan
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001327:Autoimmune Diseases / Q000453:epidemiology; D002446:Celiac Disease / Q000150:complications* / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult
keywords: celiac disease; multiple autoimmune syndrome; polyautoimmunity