Endocrine Abstracts

Introduction

Celiac disease is an autoimmune enteropathy secondary to gluten intolerance developing in genetically predisposed patients. The atypical presentation is the most common form of the disease. The aim of this work is to report the various extradigestive manifestations associated with celiac disease.

Patients and methods

This is a descriptive transversal study carried out over a period of 10 years. All patients with celiac disease were included.

Results

Forty one patients were included; the average age of patients was 36 years (17–75 years) with a sex ratio (M/F) equal to 0.46. The typical clinical presentation including chronic diarrhea and/or weight loss was observed in 29 patients, it was atypical in 10 patients and suspected in 2 asymptomatic patients with type1 diabetes. The extra-digestive manifestations associated with celiac disease were: anemia (83% of cases), amenorrhea (73% of cases), sterility (2.4% of cases), delayed puberty (2.4% of cases), coetaneous signs (12% of cases), psychiatric disorders (12% of cases), myalgia (9.7% of cases), hypocalcaemia (51% of cases), hypo albuminemia (73% of cases)), cytolysis (9.7% of cases), and cholestasis (7.3% of cases). All patients received a gluten-free diet and symptomatic treatment of extra-digestive manifestations. The evolution was marked by a clinical and biological improvement in 75% of cases.

Conclusion

Asymptomatic and atypical presentations are frequent in celiac disease, justifying a disease screening in order to start early the gluten free diet and improve the prognosis of the disease.