Diagnostics of adult forms of celiac disease: More intensive screening improves diagnosis

Abstract

Diagnosis of adult celiac disease is often a problematic part of clinical medicine. High risk groups for adult celiac disease deserve an intense search, even if atypical extra-intestinal symptoms suggest some other underlying cause. In part, diagnosis may occur over a long time period during adult years, and even then, could potentially remain undiagnosed until very late, even in very elderly stages of life. The objective of this work was to record our clinical experience with the diagnosis of adult forms of the celiac disease, in spite of their atypical presentations with extra-intestinal symptoms alone, and consider the role of serological testing for case-finding in these patients. We chose 9 adult patients with celiac disease diagnosed over a long period during an outpatient medical care by various physician specialists. Examination of autoantibodies for tissue transglutaminase, antiendomysium antibodies and autoantibodies against gliadin as well as cow's milk were done. To confirm positive autoantibodies as an indicator of adult celiac disease, samples of duodenal mucosa were taken and histopathologically examined.