ADULTHOOD COELlAC DlSEASE lN URBAN AREA OF CATANIA EASTERN SIClLY A RETROSPECTIVE STUDY

Background-Data of international literature report the key role led by genetic and environmental factors in determining clinical, serological and histopathological features of coeliac disease (CD). The disease is well defined in the childhood while there are few data about CD in the adult. Moreover could be exist differences in clinical features in relationship both to the race and the geographic area where the subjects live. Aim-The purpose of our study was to describe clinical data of CD in adult subjects living in Catania. Methods-We retrospectively examined clinical data of subjects aged >/= 16 yrs. All pts had a complete clinical examination and a blood sample was drawn for routine tests plus gliadin ab (AGA)-1986/01, plus endomysial ab (EmA)-1991/01 and plus anti-transglutaminase ab (anti-tTG)- 1999/01. All pts had II duodenum biopsies that represented the gold standard for the diagnosis of CD. Results-The clinical notes of 571 adult pts with CD were reviewed.The pts (M 184-F 387; M/F:1/2,1; range 16-81 yrs; m.a. 39,7) were diagnosed between 1982-2001. 59 pts had familiarity of I degree. 48 pts (8.4%) were diagnosed between 1982-86 (m.a.: 31.8), 106 pts (18.6%) between 1987-91 (m.a.: 34.7), 184 pts (32.2%) between 1992-96 (m.a.: 29.4) and 233 pts (40.8%) between 1997-01 (m.a.: 37.5). Only sideropenic anemia was found in 19% cases. Sideropenic anemia was associated to diarrhea, abdominal discomfort, aphthous stomatitis and short stature in 46.7% of the pts; 15.6% of pts were asymptomatic,4,2% of pts showed delayed puberty, 3,7% of pts showed anorexia, 3,2% of pts showed hypertransaminasemia, 0,7% of pts had dermatitis herpetiformis, 6,9% of pts had other symptoms. Serum positivity was found for AGA in 89.3% of 523 pts, for EmA in 97.4% of 443 pts, for anti-tTG in 100% of 129 pts. 40 pts had associated disorders: type I diabetes mellitus (1.4%), thyroid disorders (1.2%), Down’s syndrome (1.0%), epilepsy (0.8%) and dermatitis herpetiformis (0.7%). Conclusions-Clinical and laboratory features of our patients are similar to those reported in the international literature. In our area unproved knowledges of CD aetiopathogenesis and clinical aspects; the impact of media and the availability of specific haematological screening tests allowed to increase the number of diagnosed CD adult pts.