Varied presentation of celiac disease in Pakistani adults.

Celiac disease (CD) is an autoimmune enteropathy triggered by ingestion of gluten in genetically susceptible individuals. It has extremely varied clinical presentations. Diagnosis of celiac disease is made by history and clinical presentation compatible with CD, serological screening compatible with CD, histological findings compatible with CD, obvious clinical and serological response to a gluten-free diet, and exclusion of other clinical conditions mimicking CD.1 Exact prevalence of celiac disease in Pakistan is not known. Not much is known about presentation of this disease in Pakistani adults. We aimed to evaluate presentation of celiac disease in adults and its association with various conditions. This is a retrospective study of patients presented to a tertiary care hospital between 1990 and 2010. The study population consisted of adolescents and adults of age 15 years or more. Subjects were identified through using ICD-9 codes. The case notes were reviewed regarding the clinical presentation, and laboratory, endoscopic and biopsy findings. The diagnosis of celiac disease was based on criteria mentioned above. Serological screening was done by ELISA technique for anti-gliadin (IgA and IgG), and tissue transglutaminase antibodies (tTG IgA and IgG). Endoscopy with distal duodenal biopsy was also done in 39 patients. Statistical analysis was done by using Statistical Package for Social