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Celiac Diagnosis Occurring at Older Age: Presented at ACG

By Mike Fillon

ORLANDO, FL -- November 4, 2004 -- Patients are receiving initial diagnosis of celiac disease at an older age and with a shorter duration of symptoms, according to a poster presentation made at the American College of Gastroenterology 69th Annual Scientific Meeting, held here October 29th to November 3rd.

In the study, researchers analyzed the trends in clinical presentation over the last 52 years in a large cohort of 590 patients who had a diagnosis of celiac disease established by biopsy in 1 center. Patients were grouped according to year of diagnosis and the trends in age at diagnosis, duration of symptoms, and mode of presentation were compared over time. The researchers also based their analysis on symptoms at presentation, whether the condition was diagnosed through screening, and presence of malignancy.

Celiac disease is a genetic inflammatory disease of the small intestine caused by gluten intolerance. The condition causes an autoimmune reaction that causes damage to the villi in the lamina propria and crypt regions of the intestine in response to consumption of specific food-grain antigens that are found in wheat, rye, and barley. The condition is also known as celiac sprue, nontropical sprue, and gluten-sensitive enteropathy.

There was a highly significant negative linear trend in presentation with diarrhea over time (P <.001), and a positive linear trend in asymptomatic patients detected by screening (P <.001).

Trends show patients were diagnosed at an older age since 1980 (P =.007), and there was a significant downward trend in those diagnosed as children or with malignancy (P =.03; P =.02). Over the 52 years of the study, there was a markedly significant negative trend in the duration of symptoms (P =.001).

When comparing those with and without diarrhea, there was no statistical difference in age (P =.59), sex (P =.59), presence of childhood celiac disease (P =.43), or malignancies (P =.71).

"Fewer patients present with diarrhea and more are detected through screening," said researcher Devi Rampertab, MD, gastroenterologist, North Shore Long Island Jewish Health System, Long Island, New York. "The majority of patients now present as silent celiac disease, with minimal or no symptoms."


[Presentation title: Trends in Clinical Presentation of Celiac Disease From 1952-2004. Abstract 42]

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