Association of primary sclerosing cholangitis and celiac disease: a case report and review of the literature.

  • Mukherjee R
  • Egbuna I
  • Brar P
 et al. 
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Abstract

BACKGROUND/AIMS: Studies have shown that celiac disease can affect individuals in all age groups. However, few studies have described the disease in the elderly. The goal of this study is to characterize celiac disease in the elderly by comparing to a population of young adults with celiac disease. METHODS: Review of a tertiary center database of patients with celiac disease was performed to identify two groups of patients, an elderly cohort 65 years and a young adult cohort aged 18-30 years, with biopsy-confirmed celiac disease. Information obtained included symptom duration, clinical presentation, small intestinal pathology, associated conditions, and the presence of bone disease. RESULTS: Included in the study were 149 young adult and 125 elderly patients; the latter represented 12.4% of the patients in our database. The duration of symptoms prior to diagnosis was similar, 5.8 12 years and 6.14 12.6 years in the young adult and elderly cohorts, respectively (p = 0.119). There was no significant difference in the mode of presentation of illness. Diarrhea was the main presenting symptom (49% in young adults vs. 50% in the elderly, p = 0.921). There was a similar prevalence of autoimmune disease (19% in young adults vs. 26% in the elderly, p = 0.133). Thyroid disease and neuropathy were more prevalent in the elderly (p = 0.037 and p = 0.023, respectively). The degree of villous atrophy and prevalence of bone disease were similar in each group. CONCLUSIONS: Surprisingly, the presentation of celiac disease both clinically and histologically is similar in elderly and young adult patients. The factors triggering disease at any given age remain unclear and warrant further study.

Author-supplied keywords

  • adolescent
  • adult
  • autoimmune diseases
  • autoimmune diseases epidemiology
  • bone diseases
  • celiac disease
  • celiac disease diagnosis
  • celiac disease epidemiology
  • celiac disease pathology
  • comorbidity
  • female
  • humans
  • male
  • metabolic
  • metabolic epidemiology
  • osteoporosis
  • osteoporosis epidemiology
  • thyroid diseases
  • thyroid diseases epidemiology
  • young adult

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  • PMID: 20165980

Authors

  • Rupa Mukherjee

  • Ikenna Egbuna

  • Pardeep Brar

  • Lincoln Hernandez

  • Donald J McMahon

  • Elizabeth J Shane

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