Screening for celiac disease among patients of the gastroenterological profile

Aim. To determine the frequency of celiac disease (CD) among gastroenterological patients and criteria for its active detection.

Materials and methods. 1.358 patients referred for gastroenterologist consultation from 2016 to 2019 was conducted, of which 140 had CD (339 males – 24.9%; 1019 females – 75.1%). The average age was 40.4±15.4 (18–86 years). All patients were determined anti-TTG IgA, IgG, and analyzed the clinical symptoms and analysis. The results were subjected to statistical processing Statistica 13.3 (StatSoft Inc., USA).

Results. In patients without CD (1218 people), high level of anti-TTG IgA and IgG was observed in 59 (4.8%), an increase in anti-TTG IgA – in 54 (4.4%), and anti-TTG IgG – in 38 patients (3.1%). The CD diagnosis confirmed in 51 patients (4.2%). The main symptoms were diarrhea (88%), abdominal pain (60.7%), bloating (73.8%), nausea (40.3%), weight loss (44.3%). Anemia was determined in 31.6%, serum iron – 33%, hypoproteinemia – 12.6%, hypoalbuminemia – 12%, hypokalemia – 5.48%, hypocalcemia – 21.9%. An increase in the level of AST – 14.5%, ALT – 14.6%. Comparative analysis showed that in the group with newly detected CD, anemia, malabsorption syndrome, increase AST, ALT were significantly more frequent than in patients with normal antibodies, which confirms the need to detect CD among patients with these laboratory abnormalities.

Conclusion. The incidence of CD among patients with a gastroenterological symptoms was 4.2%. Analysis of clinical and laboratory data has shown that a comprehensive analysis of clinical symptoms and laboratory indicators at the stage of primary treatment will allow timely identification of CD patients and prescribe GFD.