Celiac disease: presentation with clinical and serological response

Abstract

Celiac disease occurs in nearly 1% of the population in many countries. The diagnosis depends on the mucosal duodenal biopsy, serological testing and observation of the response to gluten free diet. Prospective study was conducted in GIT center teaching hospital in Baghdad; between February 2007 and February 2008 for 30 celiac patients based on clinical, serological and histopathological background, The age of these patient range from 1 year to 40 years . Venous blood sample were taken for CBP, Coomb’s test, serology AGA IgG and IgA; OGD was done and three biopsies from the duodenum were sent for histopathological study. The study has shown female to male ratio of 1.5:1 in children, while it was the reverse in adult. Associated disorder in celiac patients were recurrent chest infection in 17/30 (56%) and autoimmune disease in 6/30(20%). The result also shows that breast feeding delays the onset of presentation in 10/30(33.3%), anemia presents in 20/30(66.7) of celiac patient. The histopathological finding of examined duodenal biopsies of celiac disease (marshIII in relation to AGA IgA) was marshIIIa10/30(33.4%)-AGAIgA8/30(26.6%),marshIIIb12/30(40%)-AGAIgA11/30(36.3),marshIII c8/30(26.6%)-AGAIgA7/30(23.3%). The present study conclude that histopathological study is still the golden standard way for the diagnosis of celiac disease while presence of AGA IgA and IgG is an indicator for the presence of celiac disease. it also shows that there is a positive relationship between celiac disease and recurrent chest infection, between celiac disease and autoimmune disease ,and positive relationship between celiac disease and positive family history as well as a positive relationship between delay onset of celiac disease and prolonged breast feeding