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• W2037055187 abstract "Objective: Celiac Disease is an immune-mediated lifetime systemic disorder of the small intestine caused by permanent intolerance to gluten and related prolamins in genetically susceptible individuals. During the last 20 years, the perception of celiac disease has changed from a rather uncommon enteropathy to a common multi-organ disease with the presence of a variable combination of clinical manifestation, CD-specific antibodies and strong genetic predisposition. Prevalence of celiac disease is high, 1:70–1:550 in the world, the expected prevalence in Slovakia is 1:250. There is a significant lack of data on the frequency of the disease in the older population. Some authors point out that up to 20% of patients with celiac disease are diagnosed after the age of sixty. Methods: Case report. Results: 83 year-old polymorbid patient was referred to the hospital for loss of appetite, diarrhea and weight loss lasting for 6 weeks. We performed blood tests, abdominal ultrasonography and computer tomography of the abdomen, which didn't show significant pathology. Infectious etiology was excluded. Gastrofibroscopy revealed erosive antrumgastropathy and erosive bulbitis, biopsy from third portion of duodenum was taken for histological examination. Because of the evidence of enterorrhagia in medical history we added colonoscopic examination. To exclude a tumor of the small intestine we performed CT enteroclysis, but both examinations did not explain the etiology of diarrhea. Despite the diet in patients with gastrointestinal distress and the use of probiotics and antidiarrheal drugs the diarrhea persisted. Enterobiopsy results have shown a significant intraepithelial lymphocytosis consistent with MARSH I. The antibody testing with a focus on celiac disease and inflammatory bowel disease were negative. The genetic test for HLA DQ 2 (present in more than 90% of patients with celiac disease) was positive. Three days after beginning the gluten free diet the clinical condition improved and the diarrhea ceased. At present, the only effective treatment of the celiac disease is lifelong gluten-free diet. Conclusions: Many patients remain undiagnosed because of frequent occurrence of extraintestinal symptoms and polymorphic clinical symptoms. Internists should not forget about celiac disease in differential diagnostic process in seniors with diarrhea, because early diagnosis and adequate treatment by dietary measures often lead to a significant improvement in the quality of life of the patient, retreat of clinical symptomatology and a reduction in the incidence of serious complications." @default.
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• W2037055187 date "2013-10-01" @default.
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• W2037055187 title "Celiac disease in elderly" @default.
• W2037055187 doi "https://doi.org/10.1016/j.ejim.2013.08.210" @default.
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