Alavinejad Pezhman, Hajiani Eskandar, Masjedizadeh Rahim, Hashemi Seyed Jalal, Faramarzi Mohammad, Sebghatollahi Vahid, Shayesteh Ali Akbar, Kadkhodae Ahmad, Jasemi Zergani Farzad, Asghari Shahnaz, Farsi Farnaz
Research Institute for Infectious Diseases of Digestive System, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran ; Assistant Professor, Gastroenterology Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Research Institute for Infectious Diseases of Digestive System, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran ; Associate Professor, Gastroenterology Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Middle East J Dig Dis. 2014 Apr;6(2):98-103.
BACKGROUND Celiac disease presents with a wide spectrum of symptoms. This study clarifies different aspects of celiac disease along with the most common patterns of celiac presentation in Khuzestan Province, Iran. METHODS Patients' information was obtained by evaluation of their files from the archives of the Khuzestan Celiac Society and records at gastroenterologists' offices in this province. RESULTS Overall, there were 103 (40 males, 63 females) patients included in this study. Patients' mean ages were 33 ± 11 years (males) and 31.6 ± 11.7 years (females). In terms of geographic distribution, 54.1% resided in the center of the province followed by 26.5% who were residents of the northern area. The rate of employment among men was 70.6% whereas it was 8.3% for women. In terms of education, 21.9% of men and 33.3% of women had academic educations. The rate of matrimony was 80.6% (n=29) for men, 65.4% (n=38) for women and 3.4% (n=2) who were divorced. Mean height was 164 ± 14 cm in men and 157.5 ± 10 cm in women. Mean BMI at the time of presentation was 22.7 in men and 22.6 in women. The most common gastrointestinal (GI) complaints in male patients were diarrhea (35%), reflux (20%), bloating (17.5%), abdominal pain (15%), vomiting (15%) and constipation (7.5%). Female patients experienced diarrhea (49.2%), abdominal pain (31.7%), bloating (31.7%), vomiting (19%), constipation(9.5%) and reflux (7.9%). The most common concomitant non-GI disorders among male patients were anemia (17.1%), thyroid disease (14.3%), and weight loss (14.3%); women experienced anemia (33.9%), thyroid disease (12.5%), and weight loss (7.1%). Approximately half of the patients exhibited symptoms for more than five years prior to diagnosis and 90% were diagnosed by gastroenterologists. Of these, 43% had normal endoscopy results. The most common serologic markers were anti-TTG (69.9%), anti-EMA (27.7%). CONCLUSION Physicians, prior to attributing patients' symptoms to irritable bowel syndrome (IBS), should be aware that patients who present with long-term nonspecific symptoms might possibly have celiac disease. During endoscopy, the threshold for obtaining biopsies should be low.
背景 乳糜泻的症状表现多种多样。本研究阐明了伊朗胡齐斯坦省乳糜泻的不同方面以及乳糜泻最常见的临床表现模式。方法 通过评估胡齐斯坦乳糜泻协会档案中的患者文件以及该省胃肠病医生办公室的记录来获取患者信息。结果 本研究共纳入103例患者（40例男性，63例女性）。患者的平均年龄男性为33±11岁，女性为31.6±11.7岁。在地理分布方面，54.1%居住在该省中部，其次是26.5%居住在北部地区。男性的就业率为70.6%，而女性为8.3%。在教育程度方面，21.9%的男性和33.3%的女性接受过高等教育。男性的结婚率为80.6%（n = 29），女性为65.4%（n = 38），离婚率为3.4%（n = 2）。男性的平均身高为164±14厘米，女性为157.5±10厘米。就诊时男性的平均体重指数为22.7，女性为22.6。男性患者最常见的胃肠道（GI）症状为腹泻（35%）、反流（20%）、腹胀（17.5%）、腹痛（15%）、呕吐（15%）和便秘（7.5%）。女性患者经历腹泻（49.2%）、腹痛（31.7%）、腹胀（31.7%）、呕吐（19%）、便秘（9.5%）和反流（7.9%）。男性患者中最常见的伴随非胃肠道疾病为贫血（17.1%）、甲状腺疾病（14.3%）和体重减轻（14.3%）；女性经历贫血（33.9%）、甲状腺疾病（12.5%）和体重减轻（7.1%）。大约一半的患者在诊断前症状出现超过五年，90%由胃肠病医生诊断。其中，43%的患者内镜检查结果正常。最常见的血清学标志物是抗组织转谷氨酰胺酶（anti-TTG，69.9%）、抗肌内膜抗体（anti-EMA，27.7%）。结论 在将患者症状归因于肠易激综合征（IBS）之前，医生应意识到出现长期非特异性症状的患者可能患有乳糜泻。在内镜检查期间，获取活检的阈值应较低。
