Rapid Communication
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jul 21, 2006; 12(27): 4416-4419
Published online Jul 21, 2006. doi: 10.3748/wjg.v12.i27.4416
Celiac disease in South-West of Iran
Rahim Masjedizadeh, Eskandar Hajiani, Jalal Hashemi, Ali Akbar Shayesteh, Karim Moula, Tahereh Rajabi
Rahim Masjedizadeh, Eskandar Hajiani, Jalal Hashemi, Ali Akbar Shayesteh, Karim Moula, From the Division of Gastroenterology and Hepatology, Department of Internal Medicine, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran
Tahereh Rajabi, Department of pathology, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran
Correspondence to: Dr. Eskandar Hajiani, Assistant Professor of Gastroenterology and Hepatology, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Golestan Hospital, Ahwaz Jundishapur University of Medical Sciences, PO Box 89, Ahwaz, Iran. ehajiani@ajums.ac.ir
Telephone: +98-611-5530222 Fax: +98-611-3340074
Received: January 25, 2006
Revised: January 28, 2006
Accepted: February 18, 2006
Published online: July 21, 2006
Abstract

AIM: Celiac disease is characterized by life-long gluten intolerance. Clinical features of patients with celiac disease are variable. Studies about the prevalence of celiac disease in our country are scarce and there is no study on the prevalence of celiac disease in southern Iran. In the current study, clinical, laboratory and histo-logical features of 52 patients with celiac disease were evaluated.

METHODS: In a cross sectional study we retrospectively studied the characteristics of 52 celiac patients at Ahwaz JundiShapour University Hospitals (AJSUH) from November 1, 1999 to 1st Sep 2004. Intestinal biopsy and serum antigliadin and anti-endomysium antibodies were used for the diagnosis of patients. Mucosal lesions were classified according to the criteria of Marsh. Antigliadin antibodies were measured with a commercial enzyme-linked immunosorbent assay. Anti-endomysium antibodies were analyzed by indirect immunofluorescence with the use of a section of monkey esophagus. Routine hematological and biochemical analyses and measurement of immunoglobulin levels were undertaken.

RESULTS: Male: female ratio was 1.08. The mean ± SD patient age was 21 ± 4.5 years (range 10-70 years) and the most common symptoms were diarrhea and weight loss (78.8%) followed by fatigue (73.1%), pallor (65.4%), anorexia (40.4%), abdominal distention (32.7%), and failure to thrive (23.1%). Diarrhea and weight loss and fatigue were the most common findings. Iron deficiency anemia was found in 63.2% of patients and this became normal after adoption of a gluten-free diet in all patients. Immunoglobulin A, IgG antigliadin antibodies and IgA anti-endomysium antibodies were found in 33 and 48 cases, 78.8% and 85.4% of patients, respectively. Biopsy of the small intestine revealed that 90.4% of patients had typical lesions according to the Marsh classification.

CONCLUSION: Although classical presentation was seen in most of the patients, atypical clinical manifestations of celiac disease should be kept in mind. In particular, patients with uncommon findings, such as short stature, and iron-deficiency anemia, should be screened for celiac disease. Further epidemiological studies in our area in the general population and in high risk groups seem to be indicated.

Keywords: Celiac disease; IgG endomysial autoantibodies; Southern Iran