A large variety of clinical features and concomitant disorders in celiac disease – A cohort study in the Netherlands

• Published in: Digestive and liver disease 2016-05, Vol.48 (5), p.499-505
• Main Authors: Spijkerman, Marleen, Tan, Ineke L, Kolkman, Jeroen J, Withoff, Sebo, Wijmenga, Cisca, Visschedijk, Marijn C, Weersma, Rinse K
• Format: Article
• Language: English
• Subjects: Abdominal Pain - etiology; Adult; Aged; Autoimmune diseases; Autoimmune Diseases - epidemiology; Celiac Disease - complications; Celiac Disease - epidemiology; Coeliac disease; Colitis, Microscopic - epidemiology; Comorbidity; Constipation - etiology; Diabetes Mellitus, Type 1 - epidemiology; Diarrhea - etiology; Enteropathy-Associated T-Cell Lymphoma - epidemiology; Fatigue - etiology; Female; Gastroenterology and Hepatology; Gastroesophageal Reflux - etiology; Graves Disease - epidemiology; Hashimoto Disease - epidemiology; Humans; Male; Middle Aged; Neoplasms - epidemiology; Netherlands - epidemiology; Prevalence; Retrospective Studies; Weight Loss; Young Adult
• ISSN: 1590-8658; 1878-3562
• DOI: 10.1016/j.dld.2016.01.006

Abstract Background and aims Celiac disease (CeD) is a gluten triggered, immune-mediated disease of the small intestine. Few clinical cohort descriptions are available, despite the diverse clinical picture. This study provides an overview of a large Dutch CeD cohort focusing on presenting symptoms, co-occurrence of immune mediated diseases (IMD) and malignancies. Methods We performed a retrospective study in a Dutch university and a non-university medical hospital and included only biopsy proven (≥Marsh type 2 classification) CeD patients. Results 412 patients were included, selected from 9468 small-bowel biopsy pathology reports and financial codes. Classical symptoms were present in approximately one third of the cohort (diarrhea (37.4%), fatigue (35.0%), weight loss (31.6%), abdominal pain (33.3%)). Atypical symptoms as constipation (10.4%) and reflux (12.4%) were reported as well. 11.7% was diagnosed without reported symptoms. In 25.2% concomitant IMD occurred (most prevalent: type 1 diabetes mellitus (4.9%), microscopic colitis (4.9%), immune mediated-thyroid disease (4.1%)). CeD patients with a concomitant IMD were diagnosed at a significantly higher age compared to those without ( P = 0.002). Malignancies occurred in 53 cases (12.9%), including eight Enteropathy Associated T-cell Lymphomas. Conclusion This is the first study describing a CeD cohort in such detail in the Netherlands and highlights the clinical heterogeneity and importance of screening for concomitant diseases in CeD.