Gillett, H.; Drummond, H.; Goddard, C.; Shand, A.; Satsangi, J.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA10
Academic Journal
Introduction: Coeliac disease (CD) is o common condition with wide clinical variation in both severity and type of symptoms. Many complications have been reported to occur but the protective effect of gluten free diet (GFD) remains controversial. The aim of this study was to provide data on the prevalence of complications and assess the effect of strict GFD in a large population with CD. Methods: Consecutive patients attending the coeliac clinic at the Western General Hospital, Edinburgh, were invited to participate. Data were collected from case notes and from questionnaires and entered onto a secure database. Results: Clinical data were obtained from 270 patients, and questionnaires completed by 199. Age at diagnosis was 0.2-88 years (median 41.5 years) with sex ratio of 1M:2.6F. Duration of follow up was 1 month to 68 years (median 6 years). Ninety one per cent reported symptoms of various severity and 9% were asymptomatic, even in retrospect. At diagnosis 75/199 (38%) were anaemic, improving to 30/225 (13%) with treatment; 16% were vitamin B12 deficient at diagnosis; 53% were iron deficient at diagnosis; and 7/32 (22%) had osteoporosis of the hip and 10/24 (42%) of the spine at diagnosis, improving to 15/130 (12%) (p = 0.006) and 34/109 (31%) (p = 0.012) with treatment. Those who described strict compliance to GFD on the questionnaire had significantly higher T scores on DEXA scan of the neck of femur compared with those who took gluten regularly (p = 0.05). T scores of the spine did not reach statistical significance. Epilepsy occurred in nine patients and was not more common in those less strict w th GFD, but in 7/9 the diagnosis of epilepsy was made before that of CD. Low birth weight (LBW) babies (< 2.5 kg occurred in 5/23 pregnancies in those regularly taking g uten and 6/146 pregnancies in those strict with diet (p = 0.005). Osteoporosis and anaemia did not differ in the symptomatic group, but LBW babies did (11/221 pregnancies v 5/24 (p = 0.011))....


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