Lorete Maria da Silva Kotze1. 1. Gastroenterology Service, Cajuru Hospital, Pontifical Catholic University of Paraná, Curitiba, PR, Brazil. loretekotze@hotmail.com
Abstract
CONTEXT: 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%). COMPLICATIONS: 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.
CONTEXT: 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%). COMPLICATIONS: 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.
Authors: Line Lund Kårhus; Tea Skaaby; Anja Lykke Madsen; Betina Heinsbæk Thuesen; Peter Schwarz; Jüri J Rumessen; Allan Linneberg Journal: United European Gastroenterol J Date: 2018-11-05 Impact factor: 4.623
Authors: Marta Silva; Armando Peixoto; Ana Luísa Santos; Pedro Costa-Moreira; Joel Ferreira da Silva; Emanuel Dias; Guilherme Macedo Journal: GE Port J Gastroenterol Date: 2020-01-10
Authors: Lorete Maria da Silva Kotze; Ana Paula Brambila Rodrigues; Luiz Roberto Kotze; Renato Mitsunori Nisihara Journal: World J Gastroenterol Date: 2009-09-21 Impact factor: 5.742