Prevalence of celiac disease in Shiraz, southern Iran

Saudi J Gastroenterol. 2008 Jul;14(3):135-8. doi: 10.4103/1319-3767.41732.

Abstract

Background/aim: This study was performed to evaluate the prevalence of celiac disease (CD) in Shiraz, southern Iran.

Materials and methods: Serum samples were collected from 1440 persons (age range = 20-83 years, mean age = 45.4 years) in 2004 and screened for endomysial and tissue transglutaminase antibodies. A questionnaire was completed for all subjects in relation to gastrointestinal (GI) symptoms and cases with positive serology were requested to undergo small-bowel biopsy.

Results: Seven cases (0.5%) were positive for IgA anti-tissue transglutaminase (anti-tTG), and only two (0.14%) were positive for IgA anti-endomysial antibody (anti-EMA), both of whom had highly positive anti-tTg levels (40.4 and 48.0 IU/l). The major clinical symptoms of CD, such as recurrent abdominal pain and change in bowel habits were present in all patients with positive anti-tTG assays. Only five subjects with positive serology agreed to undergo upper GI endoscopy and duodenal biopsy. Three of these cases were reported with Marsh I histologic findings, while in the two cases with positive serologic anti-EMA, more advanced forms of CD were present.

Conclusion: The prevalence of CD in apparently healthy adults was lower than the reported series from northern parts of the country; therefore, we suggest a more long-term follow-up study in high-risk groups, especially in the apparently healthy subjects in our region.

Keywords: Anti-endomysial antibody (anti-EMA); anti-tissue transglutaminase antibody (anti-tTG); celiac disease; southern Iran.