Molecular detection of Tropheryma whipplei, Cryptosporidium spp., and Giardia lamblia among celiac disease samples

Background: Celiac disease (CD) is one of the most common disorders, resulting from both environmental (gluten) and genetic factors. The clinical features of the Iranian CD are still unknown and there is insufficient information about the atypical presentation of CD from Iran. As, many previous reports revealed an association between controlled protozoal infections and the CD according to cytokines production, the aim of this study was to determine the prevalence of CD and possible co‑infection with the most prevalent protozoal infections including Tropheryma whipplei, Cryptosporidium, and Giardia duodenalis among CD samples. Materials and Methods: In this study, from April 2014 to November 2016, 524 samples were obtained from small intestine of patients with gastrointestinal diseases referring to the Pathology Department of Namazi Hospital, Shiraz, Iran. Multiplex polymerase chain reaction assay was then performed on the histological positive CD samples for the prevalence of the microorganisms. Results: Sixty‑four (12.21%) patients were diagnosed as having CD by histopathological examination. The prevalence of T. whipplei and Cryptosporidium spp. was 19 (29.69%) and 8 (12.5%) respectively, among CD positive samples there was no positive sample for Giardia lamblia. Conclusion: The prevalence of CD among the southwestern Iranian population was high and comparable with other areas of Iran as well as many other countries. Furthermore, no significant association between the presence of T. whipplei, Cryptosporidium spp., and level of the histopathological changes of villi in the CD was observed (P > 0.05).