Celiac disease in Chilean adults

Abstract

Introduction and aim: To characterize a university hospital population of Chilean adult patients with celiac disease. Patients and method: We retrospectively reviewed the records of patients under control that were diagnosed with celiac disease through clinical characteristics, serology, and histology. Results: A total of 149 patients were included, 119 (79.9%) of whom were women. Mean patient age was 42 years at diagnosis and 13.4% of patients had a family history of celiac disease. Mean body mass index was 24.3 kg/m2, 55.3% presented with normal weight, 37.9% with overweight and obesity, and 6.8% with underweight. The main reasons for consultation were diarrhea (47%), weight loss (31%), dyspepsia (43%), and fatigue (26.1%). Anemia (26.1%), elevated transaminases (17.4%), low ferritin (11.4%), and hypovitaminosis D (9.3%) stood out, among others, in the initial laboratory work-up. The more frequent associated diseases were hypothyroidism (15.4%) and depressive disorder (11.4%). Small intestinal bacterial overgrowth was found in 10.1% and lactose malabsorption in 15.4%. The primary histologic diagnosis was celiac disease, with Marsh stage 3a villous atrophy (34.9%). Conclusion: Our results were similar to those of other case series on adults, finding that celiac disease was more frequent in women, disease began in the fourth decade of life, extraintestinal symptoms predominated, and there was an association with other autoimmune diseases. An important percentage of patients were also overweight and obese. Resumen: Introducción y objetivo: Caracterizar una población chilena de enfermos celiacos adultos de un centro universitario. Pacientes y método: Se revisaron de manera retrospectiva los expedientes de pacientes en control con diagnóstico de EC por clínica, serología e histología. Resultados: Se incluyeron 149 pacientes, 119 mujeres (79,9%), con edad promedio de 42 años al momento del diagnóstico. Los pacientes tenían antecedentes familiares de EC en 13,4%. Índice de masa corporal promedio de 24,3 kg/m2, peso normal un 55,3%, sobrepeso y obesidad 37,9%, y bajo peso 6,8%. Los principales motivos de consulta fueron: diarrea (47%), baja de peso (31%), dispepsia (43%) y fatiga (26,1%). En el laboratorio inicial, destacaron anemia (26,1%), transaminasas elevadas (17,4%), ferritina baja (11,4%), hipovitaminosis D (9,3%), entre otros. Las patologías asociadas más frecuentes fueron hipotiroidismo (15,4%) y trastorno depresivo (11,4%). Se encontró sobrecrecimiento bacteriano en 10,1% y malabsorción de lactosa en 15,4%. El principal diagnóstico histológico fue EC con atrofia de vellosidades estadio 3a de Marsh (34,9%). Conclusión: Nuestros resultados son similares a otras series en adultos que reportan que la EC es más frecuente en mujeres, con inicio en la cuarta década de la vida, con predominio de síntomas extraintestinales y asociado con otras enfermedades autoinmunes. Existe un porcentaje importante en pacientes con sobrepeso y obesos.

Keywords

• Enfermedad celiaca
• Gluten
• Chile
• Adultos