Clinical, Serological and Histopathological Aspect of Celiac Disease at AL-Ramadi Province West of Iraq

Abstract

Yasin H. Majeed

Background: Celiac disease (CD) is a public hereditary, autoimmune &multifactorial gastro-intestinal disorder in children and adults defined as a permanent gluten-sensitive Enteropathy. There is no previous study on Socio-demographic, clinical, endoscopic, and histological features of celiac disease in the AL-Ramadi district (west of Iraq) patients.
Objective: To identify the clinical, endoscopic, and histological features of celiac disease at Al-Ramadi district (west of Iraq) to reach the accurate CD diagnosis.
Patients and Methods:161 consecutive new CD cases diagnosed in the Gastroenterology Clinic of AL-Ramadi teaching hospital between August 2017 and March 2020 were included in a retrospective cross-sectional study, of them, 85 females were females76 males. The clinical features and endoscopic findings were recorded for each CD patient. In all cases, gastro-intestinal biopsies with serum ''anti-tissue transglutaminase' (Anti¬tTG) had been determined & tested for the CD diagnosis. Histopathology results had been divided using modified Marsh taxonomy.
Results: The mean age of celiac disease patients was 24.16 ± 14.751. There was a non- statistically significant differences between the genders in studied countries (p = 0.478). Abdominal pain, Bloating, Diarrhea, vomiting, altered bowel habit, Pallor, short stature and Constipation were the most common finding of CD patients with the following percent (23.6%), (23.0%), (14.3%),7.5%,6.2%,5.0%,5.0% respectively. The CD investigations shows were: (a) IDA in 105 (65.2%) patients; (b) low ferritin in 17 (10.6%) patients; (c) elevated SGPT 3 (1.9%) patients; (d) pancytopenia and 1 (0. 6%) patients. IgA anti-tTG <10iu/ml 6.2%, IgA between 10.1-20 iu /ml 82.0% while IgA anti tTG>20iu/ml in 11.8%. A statistical correlation was found between endoscopical and histopathological findings of celiac disease (p = 0.0001), and this correlation was more prominent in the scalloping aspect of duodenal mucosa. A statistical correlation was found between Anti- tTG IgA iu /ml levels and histopathological findings of celiac disease (p = 0.0002).
Conclusion: Histopathological findings correlate both with the endoscopic finding and the IgA TTGA levels of celiac disease patients. Furthermore, half of the CD patients with Iron deficiency anemia.