Serologic celiac disease in patients with inflammatory bowel disease

Abstract

• BACKGROUND: There is an association  of celiac disease (CD) with several gastrointestinal illnesses. We aimed to determine  the prevalence of CD in patients with inflammatory bowel disease (IBD) to evaluate the value of the routine serological tests for CD in these patients.
• METHODS: patients with IBD underwent  screening test for CD. The screening test was based on IgA anti-tTG antibody evaluated by ELISA method and IgA EMA (endomysial antibody) measured by the indirect immunofluorescence method. Fisher exact and chi-square and t tests were used for data analysis.
• RESULTS: the study was conducted on 100 patients, with a mean age of 34.74 ± 12.03 (SD) years. The mean simplified Crohn’s disease activity index was 90 ± 17 (SE) and the mean colitis activity index was 3.46± 0.96 (SE). Seventeen patients (17%) had IgA anti-tTG antibody levels above the cutoff point (> 20). Thirty-two patients were positive for IgA EMA. IgA EMA was positive in nine IgA anti-tTG positive patients (three patients with Crohn’s Disease and six ones with ulcerative colitis). Then, the prevalence of serologic CD was 9% that was higher than that of general population. A significant correlation was found between the results of IgA EMA and those of IgA anti-tTG (p = 0.001) whereas Fisher exact test revealed significant difference between frequency distribution  of positive and negative results of IgA EMA and IgA anti-tTG in patients with ulcerative colitis and Crohn’s disease (p < 0.001). 
• CONCLUSIONS: the prevalence of serologic CD in general population in Iran has been reported to be 0.6–0.96%. Then, its prevalence in our sample size was about ten times more than that in general population.
• KEYWORDS: Celiac Disease, Inflammatory Bowel Disease