Serological and clinical specificities of celiac disease in adults: About 167 cases

Abstract

Celiac disease (CD) is a chronic enteropathy of autoimmune origin, secondary to an inappropriate immune response induced by gluten, in genetically predisposed individuals. It is characterized by a total or partial villous atrophy of the small intestine, at the origin of a table of malabsorption. The epidemiological view of celiac disease has evolved dramatically from a rare pediatric disease to a common pathology in all age groups, with two frequency peaks, in childhood between 6 and 24 in adulthood most o en between 20 and 40 years. The objective of our study is to establish a clinical and serological profile of CD in adults compared to that of children and infants. We performed a descriptive and prospective study, involving a cohort of 167 adults among 374 patients with confirmed CM. The search for autoantibodies was carried out by the ELISA technique for tissue anti-Transglutaminase (tTG), gliadin-depressed anti-Peptide (DGP) and indirect immunofluorescence (IFI) on organ cut for the anti-Endomysium Our study shows a female predominance that increases with age. The sex ratio in infants is 0.82, in contrast in the adult sex ratio F / H is of the order of 4.53. The sex ratio F / M in adults is 4.53. The most frequent clinical sign is skin and mucous pallor, which is the major clinical sign with a rate of around 37%, followed by diarrhea, which is found in 19% of cases. Immunological exploration shows that anti tTG-IgA antibodies are much more common in adults compared to children and infants, with a rate of around 83.35% of cases. Our study confirms the predominance of females, the high frequency of cutaneo-mucous pallor and atypical forms. Hence the interest of immunological screeninginthefaceofcrudeoratypicalforms.Immunologicalexploration and early management can prevent complications and improve the prognosis of the disease.