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Symptoms and findings in adult-onset celiac disease in a historical Danish patient cohort.

Abstract

OBJECTIVE

The presentation of celiac disease (CD) has changed over the past decades. We aimed to describe the incidence of CD and its complications at diagnosis in a historical cohort in a well-defined population in Denmark.

METHODS

We included all patients aged 15+ years, who lived in Aarhus County, Denmark, and who were diagnosed with CD between January 2008 and August 2013. Data regarding gastrointestinal symptoms, anthropometrics, biochemistry, and bone mineral density were retrieved from patient records.

RESULTS

A total of 93 patients with a valid CD diagnosis were identified, corresponding to an incidence rate of 6.4 per 100,000 person-years. At diagnosis, diarrhea and weight loss occurred in 54% and 47% patients, respectively. In total, 30% had anemia; 40%, iron deficiency; 20%, folate deficiency; and 17%, vitamin B12 deficiency. Vitamin D deficiency was present in 34%. In 28%, bone mineral density was determined during the first year after diagnosis. Of these, 54% had osteopenia and 12% osteoporosis. After introduction of a gluten-free diet, 28% had normalized transglutaminase antibody levels after 6 months, and 56% did after 12 months. Diabetes mellitus type 1 was present in 7%; dermatitis herpetiformis, in 3%; and thyroid dysfunction, in 5%.

CONCLUSIONS

Only half of newly diagnosed CD patients presented with classic gastrointestinal symptoms. Anemia and vitamin deficiencies were common. Bone mineral density was determined in less than a third of the patients, and osteoporosis occurred in 12% of these. Serologic markers of CD normalized in approximately half of patients during the first year after the diagnosis.

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  • Authors+Show Affiliations

    ,

    a Department of Hepatology and Gastroenterology , Aarhus University Hospital , Aarhus C , Denmark.

    ,

    a Department of Hepatology and Gastroenterology , Aarhus University Hospital , Aarhus C , Denmark.

    a Department of Hepatology and Gastroenterology , Aarhus University Hospital , Aarhus C , Denmark.

    Source

    MeSH

    Adolescent
    Adult
    Aged
    Anemia
    Autoantibodies
    Bone Density
    Celiac Disease
    Comorbidity
    Denmark
    Dermatitis Herpetiformis
    Diabetes Mellitus, Type 1
    Diarrhea
    Female
    Folic Acid
    Folic Acid Deficiency
    GTP-Binding Proteins
    Humans
    Incidence
    Iron
    Male
    Middle Aged
    Osteoporosis
    Retrospective Studies
    Symptom Assessment
    Thyroid Diseases
    Transglutaminases
    Vitamin B 12 Deficiency
    Vitamin D Deficiency
    Weight Loss

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    26452305

    Citation

    Schøsler, Louise, et al. "Symptoms and Findings in Adult-onset Celiac Disease in a Historical Danish Patient Cohort." Scandinavian Journal of Gastroenterology, vol. 51, no. 3, 2016, pp. 288-94.
    Schøsler L, Christensen LA, Hvas CL. Symptoms and findings in adult-onset celiac disease in a historical Danish patient cohort. Scand J Gastroenterol. 2016;51(3):288-94.
    Schøsler, L., Christensen, L. A., & Hvas, C. L. (2016). Symptoms and findings in adult-onset celiac disease in a historical Danish patient cohort. Scandinavian Journal of Gastroenterology, 51(3), pp. 288-94. doi:10.3109/00365521.2015.1092576.
    Schøsler L, Christensen LA, Hvas CL. Symptoms and Findings in Adult-onset Celiac Disease in a Historical Danish Patient Cohort. Scand J Gastroenterol. 2016;51(3):288-94. PubMed PMID: 26452305.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Symptoms and findings in adult-onset celiac disease in a historical Danish patient cohort. AU - Schøsler,Louise, AU - Christensen,Lisbet A, AU - Hvas,Christian L, Y1 - 2015/10/09/ PY - 2015/10/11/entrez PY - 2015/10/11/pubmed PY - 2016/8/26/medline KW - Celiac disease KW - epidemiology KW - osteoporosis SP - 288 EP - 94 JF - Scandinavian journal of gastroenterology JO - Scand. J. Gastroenterol. VL - 51 IS - 3 N2 - OBJECTIVE: The presentation of celiac disease (CD) has changed over the past decades. We aimed to describe the incidence of CD and its complications at diagnosis in a historical cohort in a well-defined population in Denmark. METHODS: We included all patients aged 15+ years, who lived in Aarhus County, Denmark, and who were diagnosed with CD between January 2008 and August 2013. Data regarding gastrointestinal symptoms, anthropometrics, biochemistry, and bone mineral density were retrieved from patient records. RESULTS: A total of 93 patients with a valid CD diagnosis were identified, corresponding to an incidence rate of 6.4 per 100,000 person-years. At diagnosis, diarrhea and weight loss occurred in 54% and 47% patients, respectively. In total, 30% had anemia; 40%, iron deficiency; 20%, folate deficiency; and 17%, vitamin B12 deficiency. Vitamin D deficiency was present in 34%. In 28%, bone mineral density was determined during the first year after diagnosis. Of these, 54% had osteopenia and 12% osteoporosis. After introduction of a gluten-free diet, 28% had normalized transglutaminase antibody levels after 6 months, and 56% did after 12 months. Diabetes mellitus type 1 was present in 7%; dermatitis herpetiformis, in 3%; and thyroid dysfunction, in 5%. CONCLUSIONS: Only half of newly diagnosed CD patients presented with classic gastrointestinal symptoms. Anemia and vitamin deficiencies were common. Bone mineral density was determined in less than a third of the patients, and osteoporosis occurred in 12% of these. Serologic markers of CD normalized in approximately half of patients during the first year after the diagnosis. SN - 1502-7708 UR - https://www.unboundmedicine.com/medline/citation/26452305/Symptoms_and_findings_in_adult_onset_celiac_disease_in_a_historical_Danish_patient_cohort_ L2 - http://www.tandfonline.com/doi/full/10.3109/00365521.2015.1092576 DB - PRIME DP - Unbound Medicine ER -