Abstract
Materials and Methods: This study was performed in the Department Gastroenterology, Kayseri Training and Research Hospital between January 2011 and December 2014. 102 patients with celiac disease, 72 female (70.6%), were included in the study. All patients were screened for physical examination findings, laboratory tests, as well as endoscopic and duodenal biopsy results. Results:The mean age of the 102 patients was 37 years (6±14,8). The most common initial patient complaints were iron deficiency anemia (48%), diarrhea (40%), abdominal pain-bloating (42%), weight loss (%10) and dyspepsia (7%), respectively. We observed that the most common laboratory finding was iron deficiency anemia and 18% had abnormal liver function. The most common finding from patients’ upper endoscopy were duodenal edema, mosaic pattern, scalloping and reduction of duodenal pili, respectively. We detected lack of compliance to the gluten free diet in 60% of celiac disease patients. Conclusion: We found that application form of celiac disease has changed in Turkey as in other countries and an increased proportion of patients present with atypical symptoms. A diagnosis of celiac disease that presents with atypical symptoms should be made as early as possible to prevent complications and educate patients about compliance to a gluten free diet.
Keywords
References
- 1. Rubio-Tapia A, Hill ID, Kelly CP, et al. ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease. Am J Gastroenterol 2013; 108:656–676.
- 2. Bai JC, Fried M, Corazza GR, et al. World Gastroenterology Organisation global guidelines on celiac disease. J Clin Gastroenterol 2013;47:121-6.
- 3. Naiyana G, Hugh JF, Alan T. Celiac disease: Prevalence, diagnosis, pathogenesis and treatment. World J Gastroenterol 2012;18:6036-59.
- 4. Husby S, Koletzko S, Korponay-Szabo IR, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition Guidelines for the Diagnosis of Coeliac Disease. JPGN 2012; 54:136-60.
- 5. Murray JA, Van Dyke C, Plevak MF, et al. Trends in the identification and clinical features of celiac disease in a North American community, 1950-2001. Clin Gastroenterol Hepatol 2003;1:19-27.
- 6. Lo W, Sano K, Lebwohl B, et al. Changing presentation of adult celiac disease. Dig Dis Sci 2003;48:395-8.
- 7. Rampertab SD, Pooran N, Brar P, et al. Trends in the presentation of celiac disease. Am J Med 2006;119:355.e9-14.
- 8. Nadhem ON, Azeez G, Smalligan RD, Urban S. Review and practice guidelines of celiac disease in 2014. Postgrad Med 2015;127:259-65.
- 9. Elsurer R, Tatar G, Şimşek H, et al. Celiac disease in the Turkish Population. Dig Dis Sci 2005; 136-142.
- 10. Çoban Ş, Palabıyıklıoğlu M, Örmeci N. Gluten sensitif enteropatili hastalarımızın değerlendirilmesi. Türkiye Klinikleri J of Gastroenterohepatol 2003;14:147-50.
- 11. Tikkakoski S, Savilahti E, Kolho KL. Undiagnosed coeliac disease and nutritional deficiencies in adults screened in primary health care. Scand J Gastroenterol 2007;42:60-5.
- 12. Haapalahti M, Kulmala P, Karttunen TJ, et al. Nutritional status in adolescents and young adults with screen-detected celiac disease. J Pediatr Gastroenterol Nutr 2005;40:566-70.
- 13. Meyer D, Stavropolous S, Diamond B, et al. Osteoporosis in a North American adult population with celiac disease. Am J Gastroenterol 2001;96:112-9.
- 14. Hjelle AM, Apalset E, Mielnik P, et al. Celiac disease and risk of fracture in adults--a review. Osteoporos Int 2014;25:1667-76.
- 15. Bardella MT, Vecchi M, Conte D, et al. Chronic unexplained hypertransaminasemia may be caused by occult celiac disease. Hepatology 1999;29:654-7.
- 16. Novacek G, Miehsler W, Wrba F, et al. Prevalence and clinical importance of hypertransaminasaemia in coeliac disease. Eur J Gastroenterol Hepatol 1999;11:283-8.
- 17. Castillo NE, Vanga RR, Theethira TG, et al. Prevalence of abnormal liver function tests in celiac disease and the effect of a gluten-free diet in the US population. Am J Gastroenterol 2015;110:1216-22.
- 18. Nejad MR, Alavian S. Celiac disease and abnormal liver function test. Int J Prev Med 2012;3:745-6.
- 19. Hall NJ, Rubin G, Charnock A. Systematic review: adherence to a gluten-free diet in adult patients with coeliac disease. Aliment Pharmacol Ther 2009;30:315-30.
Abstract
Giriş ve Amaç:Çölyak hastalığı tanısı almış erişkin olgularımızın klinik bulgularının, laboratuvar verilerinin ve glutensiz diyete uyumlarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem:Bu çalışma, Kayseri Eğitim ve Araştırma Hastanesi, gastroenteroloji bölümünde, Ocak 2011-Aralık 2014 tarihleri arasındaki üç yıllık süreçte izlenen yaşları 18-70 yaş arasında deği-şen, 72’si kadın (%70,6), 102 çölyak hastasının başvuru şikayetleri, laboratuvar sonuçları, endoskopi bulguları ve duodenum biyopsisi sonuçları retrospektif olarak değerlendirilmiştir. Bulgular:Çalışmaya alınan 102 olgunun yaş ortalaması 37,6±14,8 idi. Olgularımızın başvuru şikayeti en sık demir eksikliği anemisi (%48), ishal (%40), karın ağrısı- şişkinlik (%42) iken bunu kilo alım yetersizliği/ kilo kaybı (%10) ve dispepsi (%7) izlemektedir. Olgularımızın klinik tiplemesinde 49’u (%48) klasik, 50’si (%49,1) atipik, 3’ü (%2,9) asemptomatik çölyak hastalığı alt sınıfındaydı. Laboratuvar bulguları içerisinde en sık demir eksikliği anemisi görülürken olguların %18,6’da karaciğer enzim yüksekliği izlenmiştir. Hastaların üst endoskopilerinde görülen en sık bulgular sırasıyla duodenal ödem, mozaik patern, taraklanma ve pililerde silinme idi. Hastaların %60’ının diyete uymadıkları tespit edilmiştir. Sonuç:Çölyak hastalığının başvuru şekillerinin diğer ülkelerde olduğu gibi Türkiye’de de değişik olduğu ve atipik bulgularla başvuran hasta oranının artmış olduğu saptanmıştır. Bu çalışmada çölyak hastalığına bağlı oluşabilecek komplikasyonların önlenmesi için atipik bulgularla gelen hastalara mümkün olduğunca erken tanının konulması ve diyete uyum konusunda hastaların bilinçlendirilmesi gerektiği vurgulanmıştır.
Keywords
References
- 1. Rubio-Tapia A, Hill ID, Kelly CP, et al. ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease. Am J Gastroenterol 2013; 108:656–676.
- 2. Bai JC, Fried M, Corazza GR, et al. World Gastroenterology Organisation global guidelines on celiac disease. J Clin Gastroenterol 2013;47:121-6.
- 3. Naiyana G, Hugh JF, Alan T. Celiac disease: Prevalence, diagnosis, pathogenesis and treatment. World J Gastroenterol 2012;18:6036-59.
- 4. Husby S, Koletzko S, Korponay-Szabo IR, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition Guidelines for the Diagnosis of Coeliac Disease. JPGN 2012; 54:136-60.
- 5. Murray JA, Van Dyke C, Plevak MF, et al. Trends in the identification and clinical features of celiac disease in a North American community, 1950-2001. Clin Gastroenterol Hepatol 2003;1:19-27.
- 6. Lo W, Sano K, Lebwohl B, et al. Changing presentation of adult celiac disease. Dig Dis Sci 2003;48:395-8.
- 7. Rampertab SD, Pooran N, Brar P, et al. Trends in the presentation of celiac disease. Am J Med 2006;119:355.e9-14.
- 8. Nadhem ON, Azeez G, Smalligan RD, Urban S. Review and practice guidelines of celiac disease in 2014. Postgrad Med 2015;127:259-65.
- 9. Elsurer R, Tatar G, Şimşek H, et al. Celiac disease in the Turkish Population. Dig Dis Sci 2005; 136-142.
- 10. Çoban Ş, Palabıyıklıoğlu M, Örmeci N. Gluten sensitif enteropatili hastalarımızın değerlendirilmesi. Türkiye Klinikleri J of Gastroenterohepatol 2003;14:147-50.
- 11. Tikkakoski S, Savilahti E, Kolho KL. Undiagnosed coeliac disease and nutritional deficiencies in adults screened in primary health care. Scand J Gastroenterol 2007;42:60-5.
- 12. Haapalahti M, Kulmala P, Karttunen TJ, et al. Nutritional status in adolescents and young adults with screen-detected celiac disease. J Pediatr Gastroenterol Nutr 2005;40:566-70.
- 13. Meyer D, Stavropolous S, Diamond B, et al. Osteoporosis in a North American adult population with celiac disease. Am J Gastroenterol 2001;96:112-9.
- 14. Hjelle AM, Apalset E, Mielnik P, et al. Celiac disease and risk of fracture in adults--a review. Osteoporos Int 2014;25:1667-76.
- 15. Bardella MT, Vecchi M, Conte D, et al. Chronic unexplained hypertransaminasemia may be caused by occult celiac disease. Hepatology 1999;29:654-7.
- 16. Novacek G, Miehsler W, Wrba F, et al. Prevalence and clinical importance of hypertransaminasaemia in coeliac disease. Eur J Gastroenterol Hepatol 1999;11:283-8.
- 17. Castillo NE, Vanga RR, Theethira TG, et al. Prevalence of abnormal liver function tests in celiac disease and the effect of a gluten-free diet in the US population. Am J Gastroenterol 2015;110:1216-22.
- 18. Nejad MR, Alavian S. Celiac disease and abnormal liver function test. Int J Prev Med 2012;3:745-6.
- 19. Hall NJ, Rubin G, Charnock A. Systematic review: adherence to a gluten-free diet in adult patients with coeliac disease. Aliment Pharmacol Ther 2009;30:315-30.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Articles |
| Authors | |
| Publication Date | August 29, 2015 |
| Published in Issue | Year 2015 Volume: 23 Issue: 2 |