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Increased Prevalence of Celiac Disease in Patients With Dyspepsia
Maria Teresa Bardella, MD;
Giorgio Minoli, MD;
Davide Ravizza, MD;
Franco Radaelli, MD;
Pietro Velio, MD;
Maurizio Quatrini, MD;
Paolo A. Bianchi, MD;
Dario Conte, MD
Arch Intern Med. 2000;160:1489-1491.
Background Although 30% to 40% of patients with celiac disease (CD) (which affects 1 in 200 individuals) have dyspeptic symptoms, there is a lack of data concerning the prevalence of CD in patients with dyspepsia.
Methods In this prospective series, we enrolled all consecutive outpatients undergoing endoscopy of the upper gastrointestinal tract for dyspepsia at our centers between January and June 1998. The exclusion criteria were age younger than 12 years, workup or follow-up of an already known disease of the gastrointestinal tract, suspected CD, malabsorption, and/or iron-deficiency anemia.
Results Of the 3019 patients who were evaluated, 517 (17%) were eligible for the study. Endoscopic findings suggested CD in 5 cases. Celiac disease was histologically diagnosed in 6 patients (5 women and 1 man; mean age, 31.3 years; age range, 20-46 years), 3 of whom had a normal endoscopic pattern and 3 of whom had an endoscopic pattern that was consistent with CD. In the patients with histologically diagnosed CD, antiendomysium antibody positivity supported the diagnosis. The relative risk for CD was 2.32 (95% confidence interval, 1.06-5.07) in comparison with the general population and higher among females (3.22; 95% confidence interval, 1.37-7.56).
Conclusions The present results indicate that the prevalence of CD in patients with dyspepsia is twice that of the general population. Thus, serological screening for CD should be considered in the early workup of these patients to allow diagnosis and treatment of an eminently treatable disease.
From the Cattedra di Gastroenterologia, Istituto di Scienze Mediche, IRCCS Ospedale Maggiore, Milano (Drs Bardella, Ravizza, Velio, Quatrini, Bianchi, and Conte), and the Divisione di Gastroenterologia, Ospedale Valduce, Como (Drs Minoli and Radaelli), Italy.
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