The relationship between the presence of gastrointestinal symptoms and anemia, thyroid functions and bone mineral density in celiac patients

INTRODUCTION: The prevalence of typical celiac patients decreases gradually with the investigation of patients presenting with non-gastrointestinal symptoms (non-GIS) like anemia, thyroid dysfunction, liver function test anomalies and dermatitis herpetiformis. The diagnosis of atypical and subclinical celiac has also increased due to the development of immunological and genetic tests. The aim of our study is to determine the relationship between the presence of GIS and anemia, thyroid functions, and bone mineral density in celiac patients.
METHODS: The study included 230 celiac patients who were diagnosed and followed-up in our clinics between 2015-2019. The demographic and anthropometric characteristics, initial presentation complaints, disease durations, dietary compliance of the patients were documented. Presence of anemia, thyroid functions, bone mineral density were documented and its relationship with presence of GIS was analyzed.
RESULTS: The age range of the patients was 18-65 years, and the mean age was 33,4±10,6 years. A total of 170(73.9%) patients were female and the duration of disease follow-up was 4,8±3,5 years. Osteoporosis/osteopenia was found in 146(63,5%) patients, anemia was found 65(28.3%) and thyroid disfunction was found 58(25.2%). Patients without GIS were significantly more anemic than patients with GIS (39.1%, 24.1% respectively) (p<0.05). In terms of thyroid function tests, the rates were similar in both groups and there wasn't significant difference (p>0.05). Osteoporosis was significantly higher in patients with GIS (p<0.05).
DISCUSSION AND CONCLUSION: The number of patients with atypical celiac disease is increasing. Celiac disease should be considered in patients presenting with unexplained anemia, a history of thyroid disease, and abnormal bone density.