Varied presentation of celiac disease in pakistani adults

Zaigham Abbas, Sajjad Raza, Javed Yakoob, Shahab Abid, Saeed Hamid, Hasnain Shah, Wasim Jafri

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


The objective of this retrospective study was to evaluate presentation of celiac disease in adults. It included 77 patients,41 (53.2%) males with median age 26 years and median body mass index of 18 (16 - 22) kg/m2. Typical presentation withgastrointestinal symptoms was seen in 76.6%. Atypical presentation with extra intestinal complaints in 7.8% and silentpresentation in 15.6%. Major symptoms were diarrhea in 64.9%, weight loss 36.4%, abdominal pain 35.1%, vomiting32.5%, pallor 24.7%, and weakness 13%. Iron deficiency was documented in 20.8%, B12 deficiency in 9.1%, folic aciddeficiency in 6.5% and vitamin D deficiency in 10.4%. Half of the patients had haemoglobin less than 11 g/dl. Osteoporosisand osteomalacia, hypothyroidism, diabetes and atrophic gastritis were seen in 2.6% each. Raised alanineaminotransferase was documented in 23.4%. Duodenal biopsy, done in 39 patients, revealed increased intraepitheliallymphocytes in 11, along with crypt hyperplasia in 3, partial villous atrophy in 15 and sub-total villous atrophy in 10. Inconclusion, celiac disease in adults should be looked for in patients with chronic diarrhea or irritable bowel syndrome likesymptoms, underweight, anaemic, or having nutritional deficiencies.

Original languageEnglish
Pages (from-to)522-524
Number of pages3
JournalJournal of the College of Physicians and Surgeons--Pakistan : JCPSP
Issue number7
Publication statusPublished - 2013


  • Adults
  • Celiac disease
  • Clinical presentation
  • Pakistan


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