Author/Authors :
Ehsani-Ardakani, Mohammad Javad shahid beheshti university of medical sciences - Gastroenterology and Liver Diseases Research Center, تهران, ايران , Rostami Nejad, Mohammad shahid beheshti university of medical sciences - Gastroenterology and Liver Diseases Research Center, تهران, ايران , Rostami Nejad, Mohammad VU University Medical Centre - Department of Gastroenterology, Netherlands , Villanacci, Vincenzo Spedali Civili Brescia - Department of Pathology, Italy , Volta, Umberto University of Bologna - St Orsola-Malpighi Hospital - Department of Gastroenterology and Internal Medicine, Italy , Manenti, Stefania Spedali Civili Brescia - Department of Pathology, Italy , Caio, Giacomo University of Bologna - St Orsola-Malpighi Hospital - Department of Internal Medicine and Digestive Diseases, Italy , Giovenali, Paolo Ospedale Santa Maria della Misericordia - Diagnostic Cytology and Histology Unit, Italy , Becheanu, Gabriel Carol Davila University of Medicine and Pharmacy - Department of Pathology, Romania , Diculescu, Mircea Clinical of Gastroenterology and Hepatology - Fundeni Clinical Institute, Romania , Pellegrino, Salvatore University Hospital ‘‘G. Martino’’ - Regional Celiac Center, Italy , Magazzù, Giuseppe University Hospital‘‘G. Martino’’ - Regional Celiac Center, Italy , Casella, Giovanni Desio Hospital Desio - Medical Department, Italy , Bella, Camillo Di Desio Hospital Desio - Department of Pathology, Italy , Decarli, Nicola “San Giuseppe Hospital” - USL 11- Empoli Florence - Departement of Diagnostic-Unit of Pathology, Italy , Biancalani, Mauro “San Giuseppe Hospital” - USL 11- Empoli Florence - Departement of Diagnostic-Unit of Pathology, Italy , Bassotti, Gabrio University of Perugia - Gastroenterology and Hepatology Section, Department of Clinical and Experimental Medicine, Italy , Hogg-Kollars, Sabine University of Birmingham - School of Immunity and Infection, UK , Zali, Mohammad Reza shahid beheshti university of medical sciences - Gastroenterology and Liver Disease Research Center, تهران, ايران , Rostami, Kamran University of Birmingham - College of Medical and Dental Sciences, UK
Abstract :
BACKGROUND: Celiac disease (CD) may have a variety of different presentations. This study has aimed to explore the prevalence of gastrointestinal (GI) and non-GI symptoms in patients with CD according to data collected in Italy and Romania (Europe) and Iran (Middle East). METHODS: This is a retrospective cross-sectional study conducted in Iran, Romania and Italy with data collection during the period from May 2009 – May 2011. For each center we included only patients with CD that was confirmed by endoscopy, small bowel biopsies and positive serology. GI symptoms such as abdominal pain, diarrhea, constipation, nausea and vomiting, weight loss and flatulence, as well as additional signs and symptoms of iron deficiency anemia (IDA), osteoporosis, hypertransaminasemia, and other related abnormalities were collected. RESULTS: Overall, 323 women and 127 men, whose mean age at diagnosis was 34.2 ± 16.47 years were included in this study. Of these, 157 subjects (34.9%) reported at least one GI symptom. The majority of cases had the following primary presenting GI symptoms: diarrhea (13.6%), dyspepsia and constipation (4.0%). Other disease symptoms were reported by 168 (37.3%) patients. The most presenting non-GI symptoms in the majority of cases were anemia (20.7%) and osteopenia (6%). There were statistically significant differences between the majority of symptoms when we compared the reported clinical symptoms from different countries. CONCLUSION: This study indicated that upper abdominal disorders such as abdominal pain and dyspepsia were the most common primary complaints among European patients, whereas Iranian patients had complaints of diarrhea and bloating as the classic presentations of CD. For non-GI symptoms, anemia was the most frequent complaint for both Iranian and Italian patients; however it was significantly higher in Iranians
