+ Site Statistics
References:
52,654,530
Abstracts:
29,560,856
PMIDs:
28,072,755
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Trends in clinical presentation of celiac disease in the us over the last fifty years



Trends in clinical presentation of celiac disease in the us over the last fifty years



Digestive Disease Week Abstracts & Itinerary Planner : Abstract No W1379



Background: There is little data regarding the presentation of celiac disease (CD) in the US. We therefore analyzed the trends in clinical presentation in a large cohort of CD patients over the last 50 years. Methods: A database consisting of 441 (148M, 293F) biopsy-proven patients diagnosed between 1952 and 2002 was reviewed. Patients were divided into 6 groups based on year of diagnosis. The 6 groups were compared for trends in age, childhood diagnosis, mode of presentation (i.e. diarrhea, bone disease, anemia, those discovered incidentally during endoscopy, those discovered by screening relatives of patients with CD) and presence of malignancy. Results: There was a negative linear trend (p=0.001) in patients presenting with diarrhea over time. Conversely, there was a positive linear trend (p=0.001) in detection by screening relatives of CD patients. There was no statistical significance in patients presenting with bone disease, anemia or incidentally at endoscopy. In addition, patients were diagnosed at an older age since 1980 (p=0.02) and there was a significant negative linear trend in the percentage of patients with a childhood diagnosis (p=0.005). There was a positive trend, though not statistically significant (p=0.054), in the prevalence of malignancy in patients with CD over time. When comparing those with diarrhea vs those without diarrhea, there was no statistical difference in age (44.0 vs 44.6 yr, p=0.7), sex (32% M vs 35% M, p=0.4), presence of childhood disease (8% vs 9%, p=0.8), presence of autoimmune disease (20% vs 20%, p=0.9) and the prevalence of malignancies (10% vs 12%, p=0.5). Conclusion: CD is increasingly detected by screening relatives of patients with the disease. Since fewer patients are presenting with diarrhea, this suggests that the bulk of patients with CD are asymptomatic. Whether earlier detection of asymptomatic patients has an impact on morbidity of CD remains to be elucidated.

(PDF emailed within 0-6 h: $19.90)

Accession: 035985274

Download citation: RISBibTeXText

DOI: 10.1016/S0016-5085(03)83338-3


Related references

Trends in diagnosis rate and clinical presentation of adult celiac disease A 25 year prospective study. Gastroenterology 120(5 Supplement 1): A 394, 2001

The many faces of celiac disease: clinical presentation of celiac disease in the adult population. Gastroenterology 128(4 Suppl 1): S74-S78, 2005

Trends in the presentation of celiac disease. American Journal of Medicine 119(4): 355.E9-14, 2006

Changing trends in clinical form of celiac disease. Which is now the main form of celiac disease in clinical practice?. Minerva Gastroenterologica E Dietologica 48(2): 121-130, 2006

The changing clinical presentation of celiac disease. Frontiers In Celiac Disease: 22, 2008

Clinical presentation and course of celiac disease in adults. Branski, D , P Rozen And M F Kagnoff (Ed ) Frontiers Of Gastrointestinal Research, Vol 19 Gluten-Sensitive Enteropathy Viii+217p S Karger Ag: Basel, Switzerland; New York, New York, Usa Illus 141-152, 1992

Impact of modification of diagnostic techniques and criteria on the presentation of celiac disease in the last 16 years. Observation in Rome. Minerva Pediatrica 48(9): 359-363, 1996

Celiac disease and gastroesophageal reflux disease: yet another presentation for a clinical chameleon. Clinical Gastroenterology and Hepatology 9(3): 192-193, 2011

Epidemiology and clinical forms of presentation of celiac disease. Revista Espanola de Las Enfermedades del Aparato Digestivo 72(5 Pt 1): 558-563, 1987

Malt lymphoma as first clinical presentation of a celiac disease. Acta Gastro-Enterologica Belgica 61(4): 479-482, 1999

Emerging new clinical patterns in the presentation of celiac disease. Archives of Pediatrics & Adolescent Medicine 162(2): 164-168, 2008

Clinical presentation of celiac disease in the pediatric population. Gastroenterology 128(4 Suppl 1): S68-S73, 2005

Gender and clinical presentation in adult celiac disease. Scandinavian Journal of Gastroenterology 30(11): 1077-1081, 1995

Emerging New Clinical Patterns in the Presentation of Celiac Disease. Yearbook of Pediatrics 2009: 167-169, 2009

Hypochromic microcytic anemia as a clinical presentation of celiac disease. Clinical Laboratory 52(5-6): 231-236, 2006