Epidemiological, Endoscopic, Clinical, and Pathological Features of Patients with Celiac Diseases in Southern Littoral of Caspian Sea

Zohreh Bari, Mojtaba Hadipour, Hafez Fakheri, Arash Kazemi, Iradj Maleki, Tarang Taghvaei, Vahid Hosseini, Seyed Mohammad Valizadeh, Danial Masoumi, Bijan Shahbazkhani, Javad Shokri Shirvani, Sepehr Tirgar Fakheri, Reyhaneh Ebrahimi



 Celiac disease is an autoimmune disorder resulting from gluten consumption in genetically predisposed individuals. The present study investigated the epidemiological, endoscopic, and clinicopathological features of patients with celiac disease in the southern littoral of the Caspian sea.


140 patients with celiac disease were interviewed and examined regarding demographic characteristics, clinical symptoms, and serologic, endoscopic, and pathological findings.


44 (31.4%) of the patients were male and 68.6% were female. The mean age of the patients at diagnosis was 27.13±13.4 years (ranging from 2 to 60 years). The most common gastrointestinal symptoms were bloating (47.8%), abdominal pain (47.1%) and diarrhea (30.7%), respectively. Also, 17 (12.1%) patients did not complain of any gastrointestinal symptoms.
18 (12.8%) patients had aphthous stomatitis, 10.7% had dermatitis herpetiformis, 3.6% suffered from itching without a rash, two (1.4%) mentioned psoriasis and one (0.7%) had lichen planus. 19 (19.7%) of the female patients complained of menstrual bleeding disorders, 4% mentioned infertility, and 2% experienced primary amenorrhea.
The most common comorbid condition was hypothyroidism in 16 (11.4%) patients. The most common endoscopic finding was duodenal scalloping (37.25%). In addition, 7.8% of the patients had a normal endoscopic appearance. 43 (30.7%) patients were classified as Marsh IIIC, 25.7% Marsh IIIB, 17.8% Marsh IIIA, 12.8% Marsh II and 12.8% were classified as Marsh I.


 Since celiac disease can present with non-gastrointestinal manifestations and the majority of our patients had Marsh III classification, it seems that celiac disease must be considered as a routine screening test in gastrointestinal clinics, and also, it should be kept in mind as a differential diagnosis in other specialty fields.


Celiac, Epidemiology, Pathology, Endoscopy

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