More and more people with celiac disease present atypical symptoms that are clinically indistinguishable from other gastrointestinal disorders. A new study shows that upwards of 4% of people with generalized gastrointestinal complaints show elevated celiac disease antibodies when screened.
The team designed and executed a cross sectional study that included 5,176 individuals chosen randomly from self-referred patients within a primary care setting in Tehran province from 2006-2007.
In all, 670 of the 5176, or 13% of patients self-referred to a general practitioner suffered from gastrointestinal complaints. All 670 subjects with gastrointestinal symptoms underwent celiac blood tests, including total immunoglobulin A (IgA) and anti-tissue transglutaminase (tTG) antibodies. Individuals showing IgA deficiency underwent screening for IgG tTG.
Of the 670 investigated for gastrointestinal complaints, a total of 22 patients, 17 women and 5 men, showed positive anti-tTG results (95% CI: 1.70-4.30). Another 8/670 showed IgA deficiency, with 3 of those 8 subjects showing positive IgG tTG. Dyspepsia (indigestion) was the chief complaint in 25 patients withpositive blood tests and cases that were analogous to the rest of thesubjects.
In all, 3.3% of serologically screened samples excluding IgA-deficient showed celiac disease antibodies, compared to 3.7% of those IgA-deficient subjects with positive tTG-IgG.
Generalized gastrointestinal complaints are a common indication of atypical celiac disease. This study points to high rates of celiac disease antibodies among patients with generalized gastrointestinal symptoms (3.7%).
Clinicians and patients will benefit from greater vigilance regarding atypical presentation of celiac disease and its association with generalized gastrointestinal symptoms.
Journal of Gastrointestinal Liver Disease - September 2009 Vol.18 No 3, 285-291