Clinical Spectrum of Celiac Disease among Adult Population: Experience from Largest Tertiary Care Hospital in Karachi, Pakistan.

Nazish Butt, Bushra Shahid, Sehrish Butt, Murk Mujahid Channa, Sehrish Reema, Ali Akbar
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Abstract

Introduction: Celiac disease (CD) is a systemic autoimmune enteropathy triggered by dietary gluten in genetically susceptible individuals. Celiac disease affects 0.6-1.0% of the population worldwide. The prevalence of CD in Pakistan is yet unknown due to under diagnosis and lack of awareness.

Objective: To determine a vast variety of presenting features in subtypes of CD to overcome the burden of disease.

Materials and methods: This was a prospective, comparative, cross-sectional study conducted at Gastroenterology department of Jinnah Postgraduate Medical Center, Karachi from December 2022 till June 2023. This study included all adult patients ≥18 years diagnosed with CD on the basis of clinical presentation, positive IgA and IgG anti-transglutaminase antibodies (value >12 IU/mL detected by ELISA followed by small intestinal biopsy classified as per Marsh criteria. The data obtained were analyzed on the statistical software SPSS version 23. Descriptive statistics were obtained by frequencies and percentages.

Results: About 142 patients were enrolled in the study, 103 (91.5%) had classical CD (CCD) whereas 36 (25%) had non-classical (NCCD). About 89 (62.7%) were females and 53 (37.3%) were males. The mean age was found to be 23 ± 6 years. Nutritional deficiencies including anemia, B12, folate, osteopenia and low body mass index (BMI) <18 was found more in CCD group as compared with NCCD group with significant p-values. Titers of anti-TTG between CCD and NCCD were not statistically significant. Hypothyroidism and PCOS were the most common associated conditions observed in adult CD patients.

Conclusion: In conclusion, CD in adults and has diverse presentations. Adults with unexplained extra-intestinal symptoms like anemia and bone pain should be investigated for CD.

How to cite this article: Butt N, Shahid B, Butt S, et al. Clinical Spectrum of Celiac Disease among Adult Population: Experience from Largest Tertiary Care Hospital in Karachi, Pakistan. Euroasian J Hepato-Gastroenterol 2024;14(1):24-29.

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成人乳糜泻的临床表现:巴基斯坦卡拉奇最大的三级医院的经验。
导言:乳糜泻(Celiac disease,CD)是一种全身性自身免疫性肠病,由遗传易感人群饮食中的麸质引发。全球有 0.6-1.0% 的人患有乳糜泻。由于诊断不足和缺乏认识,巴基斯坦的乳糜泻发病率尚不清楚:确定 CD 亚型的各种表现特征,以减轻疾病负担:这是一项前瞻性、比较性、横断面研究,于2022年12月至2023年6月在卡拉奇真纳研究生医疗中心消化内科进行。研究对象包括所有根据临床表现、IgA 和 IgG 抗转谷氨酰胺酶抗体阳性(ELISA 检测值大于 12 IU/mL,然后根据巴什标准进行小肠活检)诊断为 CD 的≥18 岁成年患者。获得的数据通过 SPSS 23 版统计软件进行分析。通过频率和百分比进行描述性统计:约有 142 名患者参与了研究,其中 103 人(91.5%)患有典型 CD(CCD),36 人(25%)患有非典型 CD(NCCD)。约 89 人(62.7%)为女性,53 人(37.3%)为男性。平均年龄为 23 ± 6 岁。营养缺乏包括贫血、B12、叶酸、骨质疏松症和低体重指数(BMI)。CCD 和 NCCD 之间的抗-TTG 滴度无统计学意义。甲状腺功能减退症和多囊卵巢综合症是成人 CD 患者最常见的相关疾病:总之,成人 CD 的表现多种多样。有不明原因的肠道外症状(如贫血和骨痛)的成人应接受 CD 检查:Butt N, Shahid B, Butt S, et al:巴基斯坦卡拉奇最大三级医院的经验。Euroasian J Hepato-Gastroenterol 2024;14(1):24-29.
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