Disease specific symptoms indices in patients with celiac disease-A hardly recognised entity

Shaista Jabeen; Azmat Ullah Khan; Waqas Ahmed; Mansur-Ud-Din Ahmad; Saghir Ahmad Jafri; Umar Bacha; Amjed Ali; Hafiz Shehzad Muzammil; Suliman A Alsagaby; Waleed Al Abdulmonem; Mohamed A Abdelgawad; Mishal Riaz; Mahwish; Makia Nasir; Aimen Zafar; Tabussam Tufail; Muhammad Imran; Tallat Anwar Faridi; Maria Aslam; Syedda Fatima Abid Shah; Sana Farooq; Tayyaba Niaz Awan; Habib Ur-Rehman

doi:10.3389/fnut.2022.944449

Disease specific symptoms indices in patients with celiac disease-A hardly recognised entity

Front Nutr. 2022 Sep 7:9:944449. doi: 10.3389/fnut.2022.944449. eCollection 2022.

Authors

Shaista Jabeen^{1

2}, Azmat Ullah Khan², Waqas Ahmed², Mansur-Ud-Din Ahmad³, Saghir Ahmad Jafri⁴, Umar Bacha⁵, Amjed Ali⁶, Hafiz Shehzad Muzammil⁷, Suliman A Alsagaby⁸, Waleed Al Abdulmonem⁹, Mohamed A Abdelgawad¹⁰, Mishal Riaz², Mahwish¹¹, Makia Nasir¹², Aimen Zafar¹³, Tabussam Tufail², Muhammad Imran^{14

15}, Tallat Anwar Faridi^{16

17}, Maria Aslam², Syedda Fatima Abid Shah², Sana Farooq², Tayyaba Niaz Awan¹⁸, Habib Ur-Rehman²

Affiliations

¹ Department of Food Science and Human Nutrition, University of Veterinary and Animal Sciences, Lahore, Pakistan.
² Faculty of Allied Health Sciences, University Institute of Diet and Nutritional Sciences, The University of Lahore, Lahore, Pakistan.
³ Department of Epidemiology and Public Health, University of Veterinary and Animal Sciences, Lahore, Pakistan.
⁴ Nur Internationl University, Lahore, Pakistan.
⁵ Department of Nutrition Sciences, University of Management and Technology, Lahore, Pakistan.
⁶ Faculty of Allied Health Sciences, University Institute of Physical Therapy, The University of Lahore, Lahore, Pakistan.
⁷ National Institute of Food Science and Technology, University of Agriculture Faisalabad, Faisalabad, Pakistan.
⁸ Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia.
⁹ Department of Pathology, College of Medicine, Qassim University, Buraydah, Saudi Arabia.
¹⁰ Department of Pharmaceutical Chemistry, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia.
¹¹ Institute of Home Sciences, University of Agriculture Faisalabad, Faisalabad, Pakistan.
¹² The Physio College of Rehabilitation, Multan, Pakistan.
¹³ University Institute of Food Science and Technology, The University of Lahore, Lahore, Pakistan.
¹⁴ Department of Food Science and Technology, University of Narowal, Narowal, Pakistan.
¹⁵ Food, Nutrition and Lifestyle Unit, King Fahed Medical Research Center, Clinical Biochemistry Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
¹⁶ Faculty of Allied Health Sciences, University Institute of Public Health, The University of Lahore, Lahore, Pakistan.
¹⁷ Health Services Academy, Islamabad, Pakistan.
¹⁸ Hussain Memorial Hospital, Lahore, Pakistan.

Abstract

Background: Celiac disease (CD) was considered a rare disease before and was perceivably only limited to children but now affects almost 1-2% of the global population. This abrupt increase in prevalence is due to advancements in diagnostic criteria and medical facilities but still many countries lack the basic data that can assess the severity of this health issue. The present study was conducted with the aim to assess the common but rarely diagnosed condition with the identification of its underlying secondary ailments.

Materials and methods: Patients visiting public sector hospitals were recruited and tested for clinical symptoms secondary to gluten-containing foods (wheat and barley, etc.), followed by serological testing for immunoglobulin A, tissue transglutaminase A, and anti-endomysial antibodies. Only seropositive candidates were included in the endoscopic and biopsy examination for the features of villous atrophy and intestinal cell damage. The secondary ailments including anemia, growth retardation, and gastrointestinal symptoms were also documented for the tested positive patients. The modified European Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) criterion was followed throughout the study.

Results: From 647 suspected cases from March 2018 to July 2019, 113 were confirmed with CD while 58% were female children and 42% were male children. The majority of them were from a lower class (75%) and 26% of them had a positive family history of CD. A total of 67% of patients with CD were underweight while wasting was observed in 38%, and 80% were stunted as well. Of the positively tested patients with CD, 49% had moderate anemia with 15% having severe anemia. Approximately 33% had hypoalbuminemia as well. The majority of them had a mild to severe range of gastrointestinal symptoms, such as abdominal pain, diarrhea, flatus, eructation, diarrhea, and steatorrhea.

Conclusion: The study finding indicates an increased number of patients diagnosed with CD with an excessive sum of secondary ailments, such as anemia, growth failure, growth retardation, malnutrition, and gastrointestinal symptoms.

Keywords: anemia; celiac disease; gastrointestinal discomforts; hypoalbuminemia; wasting.

Copyright © 2022 Jabeen, Khan, Ahmed, Ahmad, Jafri, Bacha, Ali, Muzammil, Alsagaby, Al Abdulmonem, Abdelgawad, Riaz, Mahwish, Nasir, Zafar, Tufail, Imran, Anwar Faridi, Aslam, Abid Shah, Farooq, Awan and Ur-Rehman.