Abstract
Celiac disease (CD) is an immune-mediated disorder that may be associated with various diseases that share a similar pathogenic immune mechanism. This study reports on the prevalence of various diseases in a cohort of CD patients in northern India. Patients diagnosed with CD based on modified ESPGHAN criteria were prospectively evaluated for associated concomitant diseases. Of the 363 patients evaluated, 207 (57.0 %) were male. The mean age was 19 years. Seventy-one percent of patients presented with typical diarrheal disease, while 29 % presented with atypical nondiarrheal disease. One or more associated diseases were noted in 70 (19.2 %) patients. Liver diseases were the most common association. Portal hypertension was present in 33 (9 %) patients; chronic liver disease was the underlying cause in 17 patients, while noncirrhotic causes were noted in 16 patients. Type 1 diabetes was seen in 13 and hypothyroidism in 11 patients. Other unreported or rarely reported associated diseases were also found in some of the patients. Associated comorbid diseases are common, and may need to be actively screened, in Indian CD patients.
References
Makharia GK, Verma AK, Amarchand R, et al. Prevalence of celiac disease in the northern part of India: a community based study. J Gastroenterol Hepatol. 2011;26:894–900.
Farrel RJ, Kelly CP. Celiac sprue. N Engl J Med. 2002;346:180–8.
Bhattacharya M, Kapoor S, Dubey AP. Celiac disease presentation in a tertiary referral centre in India: current scenario. Indian J Gastroenterol. 2013;32:98–102.
Ventura A, Magazzu G, Greco L. Duration of exposure to gluten and risk for autoimmune disorders in patients with celiac disease. SIGEP Study Group for Autoimmune Disorders in Celiac Disease. Gastroenterology. 1999;117:297–303.
Sategna Guidetti C, Solerio E, Scaglione N, et al. Duration of gluten exposure in adult coeliac disease does not correlate with the risk for autoimmune disorders. Gut. 2001;49:502–5.
Collin P, Reunala T, Pukkala E, et al. Coeliac disease-associated disorders and survival. Gut. 1994;35:1215–8.
Strober W. Gluten-sensitive enteropathy. In: King R, Rotter JI, Motuslky AG, (eds). Genetic Basis of Common Diseases. New York: Oxford University Press; 1992. p. 279–304.
Anonymous. Revised criteria for the diagnosis of coeliac disease. Report of Working Group of European Society of Paediatric Gastroenterogy and Nutrition. Arch Dis Child. 1990; 65:909–11
Oberhuber G, Granditsch G, Vogelsang H. The histopathology of celiac disease: time for standardized repot scheme for pathologists. Eur J Gastroenterol Hepatol. 1999;11:1185–94.
Agarwal N, Puri AS, Grover R. Non-diarrheal celiac disease: a report of 31 cases from northern India. Indian J Gastroenterol. 2007;26:122–6.
Sainsbury A, Fitzgerald T, Davies H, Howdle PD, Everett SM, Jennings JS. Prevalence of cryptogenic transaminitis in the Leeds coeliac cohort. Gut. 2011;60:A91. doi:10.1136/gut.2011.239301.188
Makharia GK, Baba CS, Khadgawat R, et al. Celiac disease: variations of presentations in adults. Indian J Gastroenterol. 2007;26:162–6.
Maki M, Mustalahti K, Kokkonen J, et al. Prevalence of celiac disease among children in Finland. N Engl J Med. 2003;348:2517–24.
Smyth DJ, Plagnol V, Walker NM, et al. Shared and distinct genetic variants in type 1 diabetes and celiac disease. N Engl J Med. 2008;359:2767–77.
Midhagen G, Järnerot G, Kraaz W. A study of prevalence and associated diseases. Scand J Gastroenterol. 1988;23:1000–4.
Sategna-Guidetti C, Volta U, Ciacci C, et al. Prevalence of thyroid disorders in untreated adult celiac disease patients and effect of gluten withdrawal: an Italian multicenter study. Am J Gastroenterol. 2001;96:751–7.
Lubrano E, Ciacci C, Ames PR, et al. The arthritis of coeliac disease: prevalence and pattern in 200 adult patients. Br J Rheumatol. 1996;35:1314–8.
Cataldo F, Marino V, Ventura A, Bottaro G, Corazza GR. Prevalence and clinical features of selective immunoglobulin A deficiency in coeliac disease: an Italian multicentre study. Italian Society of Paediatric Gastroenterology and Hepatology (SIGEP) and “Club del Tenue” Working Groups on Coeliac Disease. Gut. 1998;42:362–5.
Holmes GK, Wills AJ. The prevalence of epilepsy in patients with celiac disease. Epilepsia. 2004;45:1291–3.
Gale L, Wimalaratna H, Brotodiharjo A, Duggan JM. Down’s syndrome is strongly associated with coeliac disease. Gut. 1997;40:492–6.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Nijhawan, S., Katiyar, P., Nagaich, N. et al. Prevalence of associated disorders in Indian patients with celiac disease. Indian J Gastroenterol 32, 330–334 (2013). https://doi.org/10.1007/s12664-013-0345-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12664-013-0345-y