Clinical research studyTrends in the Presentation of Celiac Disease
Section snippets
Study Design and Subjects
All patients presenting to the Celiac Disease Center at Columbia Presbyterian Medical Center in New York City between 1981 and 2004 were entered into a database that was anonymized to protect patient privacy. Patients seen before 1990 were retrospectively entered; subsequent data were entered prospectively. Data including age, gender, date of diagnosis, age at initial diagnosis, presence or absence of small bowel biopsy, duration of symptoms before diagnosis, and mode of presentation were
Clinical Features and Modes of Presentation of Patient Population
A total of 590 patients with biopsy-proven celiac disease were included in the study. The patients were predominantly women (401 women and 189 men, ratio 2.1:1). Mean age at diagnosis was 43.4 ± 17.4 years (range 16-83 years). The mean age at diagnosis was similar in men and women (44.9 ± 18.7 years and 42.7 ± 16.8 years, respectively; P = 0.16). Of the 590 patients, 25.1% had a known family history of celiac disease, and 9% were initially diagnosed in childhood and subsequently rediagnosed as
Discussion
Serologic screening studies from several countries have demonstrated celiac disease to be common, occurring in approximately 1% of the population.6, 7, 8 This far exceeds the prevalence of clinically diagnosed celiac disease,9 indicating that the majority of those with celiac disease are currently undiagnosed. In addition, there have been only 2 recent studies describing the clinical presentation of celiac disease in the United States.3, 4 In each of these studies, there was recognition that
Conclusion
Celiac disease is becoming increasingly recognized in the adult population without diarrhea, with a larger percentage of patients presenting as asymptomatic individuals often detected by screening affected families. The atypical forms are, in fact, becoming the typical. The natural history of this milder form of celiac disease has not been determined.
References (18)
- et al.
Coeliac disease
Lancet
(2003) - et al.
Trends in the identification and clinical features of celiac disease in a North American community, 1950-2001
Clin Gastroenterol Hepatol
(2003) - et al.
The clinical pattern of subclinical/silent celiac diseasean analysis on 1026 consecutive cases
Am J Gastroenterol
(1999) - et al.
Breast-feeding protects against celiac disease
Am J Clin Nutr
(2002) - et al.
Risk of malignancy in patients with celiac disease
Am J Med
(2003) On the Coeliac Affection
Saint Bartholomew’s Hospital Reports
(1888)- et al.
Changing presentation of adult celiac disease
Dig Dis Sci
(2003) - NIH Consensus Development Conference on Celiac Disease. Available at:...
- et al.
Prevalence of celiac disease among children in Finland
N Engl J Med
(2003)
Cited by (251)
Serum zonulin level as a novel approach in diagnosis and follow-up of patients with celiac disease. A systematic review and meta-analysis
2024, Nutrition Clinique et MetabolismeCeliac disease
2023, Revue de Medecine InterneCeliac disease and mental health—A concealed association
2023, American Journal of the Medical SciencesDermatitis herpetiformis -- a cutaneous manifestation of coeliac disease
2021, Coeliac Disease and Gluten-Related DisordersPrevalence of Celiac Disease in Patients With Liver Diseases: A Systematic Review and Meta-Analyses
2023, American Journal of Gastroenterology