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Celiac Disease Shows Similar Presentations in Elderly and Young Adult Populations

Celiac.com 03/12/2010 - A team of researchers recently noted similar presentations of celiac disease in both elder and younger patients. The research team included Rupa Mukherjee, Ikenna Egbuna, Pardeep Brar, Lincoln Hernandez, Donald J. McMahon, Elizabeth J. Shane, Govind Bhagat, and Peter H. R. Green. They are affiliated variously with the Division of Digestive and Liver Diseases, the Division of Endocrinology, Department of Medicine, and the Department of Pathology at the Columbia University College of Physicians and Surgeons in New York, and with Columbia University Medical Center's Celiac Disease Center.

It is well known that celiac disease can affect individuals of all ages. However, there have been few studies to focus solely on how celiac disease presents among elderly people. To get a better understanding of how celiac disease presents in the elderly, a research team recently set out to compare aspects of celiac disease from elderly populations with a population of young adults with celiac disease.

The first step was to assemble two groups of patients, an elderly cohort over 65-years old, and a young adult cohort aged 18–30 years, with biopsy-confirmed celiac disease. They did this by reviewing a tertiary center database of celiac disease patients with celiac disease, which provided data on symptom duration, clinical presentation, small intestinal pathology, associated conditions, and the presence of bone disease.

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The team reviewed data on 149 young adult and 125 elderly patients with celiac disease; The elderly subjects comprised 12.4% of the patient database. Both groups showed similar duration of symptoms before diagnosis, with young adults at 5.8 ± 12 years and elderly at 6.14 ± 12.6 years, respectively (p = 0.119).

The presenting symptoms were also basically the same for both groups, with diarrhea being the main presenting symptom in 49% of young adults and 50% of the elderly (p = 0.921). Both groups showed similar rates of autoimmune disease, with 19% of young adult and 26% of elderly patients having relevant autoimmune conditions (p = 0.133). Both groups showed similar presence of villous atrophy and rates of bone disease, while the elderly group showed higher rates of thyroid disease and neuropathy (p = 0.037 and p = 0.023, respectively).

The team expressed surprise that, both clinically and histologically, celiac disease seems to present similarly in elderly and young adult patients. They note that since the exact causes for celiac disease at any given age remain unclear and warrant further study.

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