Document Detail


Celiac disease in osteoporotic Indians.
MedLine Citation:
PMID:  15266924     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: 1) The aim of the study was to identify the atypical celiac disease (CD) in a cohort of symptomatic osteoporotic patients, younger than 55 years of age and 2) To study associated clinical and laboratory features and outcome with gluten-free diet. MATERIAL AND METHODS: We studied 33 patients (F:M = 28:5), mean age 29 years (range 15-52 years) with osteoporosis (WHO diagnostic criteria, T-score less than -2.5 on DEXA scan) from January 2000 - June 2002. Serological screening for CD was done by detecting circulating IgA antibodies to tissue transglutaminase by ELISA. Patients with presence of antibodies to transglutaminase were subjected to biopsy from the 2nd part of the duodenum by upper GI endoscopy. The biopsies were reported independently by two pathologists who were blinded for the serology report. Measurement of mucosal thickness, crypts and villi were done with an ocular micrometer. Other parameters like complete hemogram, serum iron, total iron binding capacity (TIBC), calcium profile, 25-OH-D, parathyroid hormone (PTH) were evaluated. Assessment of clinical and laboratory parameters was performed within 4-12 weeks of starting gluten-free diet (GFD). RESULTS: Thirteen patients had circulating IgA antibodies to transglutaminase. Intestinal biopsies were performed on 11 patients and were consistent with the diagnosis of CD (total villous atrophy--two, subtotal villous atrophy with crypt hyperplasia--nine). Patients with CD had significant anaemia when compared with non-CD osteoporotic patients. Other important observations in these 11 patients were low serum calcium and phosphorus, low 25-OH-D, high PTH. Significant improvement in clinical and laboratory parameters was noted in all patients within 6-12 weeks of starting GFD. CONCLUSION: Symptomatic osteoporotic patients (younger than 55 years of age) especially with associated anaemia should be investigated for CD. Simple measures like omission of wheat from diet (GFD) lead to significant improvement in symptoms within weeks.
Authors:
Y A Gokhale; P D Sawant; C M Chodankar; N D Desai; M V Patil; S Maroli; M N Patil; N K Hase
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of the Association of Physicians of India     Volume:  51     ISSN:  0004-5772     ISO Abbreviation:  J Assoc Physicians India     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2004-07-22     Completed Date:  2004-08-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7505585     Medline TA:  J Assoc Physicians India     Country:  India    
Other Details:
Languages:  eng     Pagination:  579-83     Citation Subset:  IM    
Affiliation:
Department of Medicine, Gastroenterology, Pathology and Pharmacology, Lokmanya Tilak Medical College and General Hospital, Sion, Mumbai.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Celiac Disease / complications,  diagnosis*,  pathology
Duodenum / pathology
Female
Humans
Intestinal Mucosa / pathology
Male
Middle Aged
Osteoporosis / etiology*

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