Irish Journal of Medical Science

, Volume 181, Issue 2, pp 225–229 | Cite as

Adult coeliac disease in Ireland: a case series

  • A. Saleem
  • H. J. O’. Connor
  • P. O’. Regan
Original Article



The clinical spectrum of adult coeliac disease (ACD) is varied with limited Irish data.

Aims and Objectives

The aim of this study was to analyse the presenting symptoms, associated conditions and complications in a consecutive series of patients with ACD.


Data were obtained from database on patients with ACD between 1988 and 2004.


One hundred and six patients (69F:37M, mean age: 46, range: 23–95 years) were included. The modes of presentation were diarrhoea in 44 patients (45%), weight loss in 41 (42%), anaemia in 37 (38%), abdominal pain in 15 (15%), fatigue in 8 (8%), hypocalcaemia in 4 (4%) and steatorrhoea in 4 (4%). Associated conditions included thyroid disorders in 7 patients (7%), bipolar affective disorder in 4 (4%), major depression in 3 (3%), rheumatoid disease in 3 (3%), inflammatory bowel disease in 4 (4%) and type I diabetes mellitus in 2 (2%). Malignancy emerged as a major complication in 15 patients (15%)


The presenting features of ACD are diverse and associated with high risk of malignancy.


Coeliac disease Associated conditions Autoimmune disease 


Conflict of interest



  1. 1.
    Kennedy NP, Feighery C (2009) Clinical features of coeliac disease today. Biomed Pharmacother 54(7):373–380Google Scholar
  2. 2.
    Aziz I, Evans K, Papageorgiou V et al (2011) Are patients with coeliac disease seeking alternative therapies to gluten free diet? J Gastrointestin Liver Dis 20(1):27–31Google Scholar
  3. 3.
    Green PHR, Stavropoulos SN, Panagi SG et al (2001) Characteristics of adult celiac disease in the USA: results of a national survey. Am J Gastroenterol 96(1):126–131PubMedCrossRefGoogle Scholar
  4. 4.
    Feighery C (1999) Fortnightly review: coeliac disease. BMJ 319(7204):236–239PubMedCrossRefGoogle Scholar
  5. 5.
    Gasbarrini G, Malandrino N, Giorgio V et al (2008) Celiac disease: what’s new about it? Dig Dis 26(2):121–127PubMedCrossRefGoogle Scholar
  6. 6.
    Green PH, Fleischauer AT, Bhagat G et al (2003) Risk of malignancy in patients with celiac disease. Am J Med 115(3):191–195PubMedCrossRefGoogle Scholar
  7. 7.
    Lombardo T, Ximenes B, Ferro G (2006) Hypochromic microcytic anemia as a clinical presentation of celiac disease. Clin Lab 52(5–6):231–236PubMedGoogle Scholar
  8. 8.
    Ransford RA, Hayes M, Palmer M et al (2002) A controlled, prospective screening study of celiac disease presenting as iron deficiency anemia. J Clin Gastroenterol 35(3):228–233PubMedCrossRefGoogle Scholar
  9. 9.
    De Freitas IN, Sipahi AM, Damiao AO et al (2002) Celiac disease in Brazilian adults. J Clin Gastroenterol 34(4):430–434PubMedCrossRefGoogle Scholar
  10. 10.
    Ciacci C, Cirillo M, Sollazzo R et al (1995) Gender and clinical presentation in adult celiac disease. Scand J Gastroenterol 30(11):1077–1081PubMedCrossRefGoogle Scholar
  11. 11.
    Sachdev A, Srinivasan V, Maheswary S et al (2002) Adult onset celiac disease in North India. Trop Gastroenterol 23(3):117–119PubMedGoogle Scholar
  12. 12.
    McElvaney NG, Duignan R, Fielding JF (1992) Coeliac disease: clinical presentations, correlations of dietary compliance, symptomatic response and repeat biopsy findings. Ulster Med J 61(2):134–138PubMedGoogle Scholar
  13. 13.
    Hankey GL, Holmes GK (1994) Coeliac disease in the elderly. Gut 35(1):65–67PubMedCrossRefGoogle Scholar
  14. 14.
    Rampertab SD, Pooran N, Brar P et al (2006) Trends in the presentation of celiac disease. Am J Med 119(4):355.e9–14Google Scholar
  15. 15.
    Freeman HJ (1998) Survey of gastroenterologists on the diagnosis and treatment of adult patients with celiac disease in British Columbia. Can J Gastroenterol 12(2):149–152PubMedGoogle Scholar
  16. 16.
    Brar P, Kwon GY, Egbuna II et al (2007) Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease. Dig Liv Dis 39(1):26–29CrossRefGoogle Scholar
  17. 17.
    Murray JA, Rubio-Tapia A, Van Dyke CT et al (2008) Mucosal atrophy in celiac disease: extent of involvement, correlation with clinical presentation, and response to treatment. Clin Gastroenterol Hepatol 6(2):186–193PubMedCrossRefGoogle Scholar
  18. 18.
    Rubio-Tapia A, Murray JA (2007) The liver in celiac disease. Hepatology 46(5):1650–1658PubMedCrossRefGoogle Scholar
  19. 19.
    Dewar DH, Ciclitria PJ (2005) Clinical features and diagnosis of celiac disease. Gastroenterology 128(4 Suppl 1):S19–S24PubMedCrossRefGoogle Scholar
  20. 20.
    Abdo A, Meddings J, Swain M (2004) Liver abnormalities in celiac disease. Clin Gastroenterol Hepatol 2(2):107–112PubMedCrossRefGoogle Scholar
  21. 21.
    Bardella MT, Vecchi M, Conte D et al (1992) Chronic unexplained hypertransaminasemia may be caused by occult celiac disease. Hepatology 29(3):654–657CrossRefGoogle Scholar
  22. 22.
    Volta U, De Franceschi L, Lari F et al (1998) Coelic disease hidden by cryptogenic hypertransaminasaemia. Lancet 325(9121):26–29CrossRefGoogle Scholar
  23. 23.
    Mahmud FH, Murray JA, Kudva YC et al (2005) Celiac disease in type 1 diabetes mellitus in a North American community: prevalence, serologic screening, and clinical features. Mayo Clin Proc 80(11):1429–1434PubMedCrossRefGoogle Scholar
  24. 24.
    Gasbarrini G, Ciccocioppo R, De Vitis I et al (2001) Coeliac disease in the elderly. A multicentre Italian study. Gerontology 47(6):306–310PubMedCrossRefGoogle Scholar
  25. 25.
    Tursi A, Giorgetti G, Brandimarte G et al (2001) Prevalence and clinical presentation of subclinical/silent celiac disease in adults: an analysis on a 12 year observation. Hepatogastroenterology 48(38):462–464PubMedGoogle Scholar
  26. 26.
    Cuoco L, Certo M, Jorizzo RA et al (1999) Prevalence and early diagnosis of coeliac disease in autoimmune disorders. Ital J Gastroenterol Hepatol 31(4):283–287PubMedGoogle Scholar
  27. 27.
    Holmes GK (1996) Non malignant complications of coeliac disease. Acta Paediatr Suppl 412:68–75PubMedCrossRefGoogle Scholar
  28. 28.
    Addolorato G, Leggio L, D’Angelo C et al (2008) Affective and psychiatric disorders in celiac disease. Dig Dis 26(2):140–148PubMedCrossRefGoogle Scholar
  29. 29.
    Askling J, Linet M, Gridley G et al (2002) Cancer incidence in a population- based cohort of individuals hospitalized with celiac disease or dermatitis herpetiformis. Gastroenterology 123(5):1428–1435PubMedCrossRefGoogle Scholar
  30. 30.
    Farrell RJ, Kelly CP (2002) Coeliac Sprue. N Engl J Med 346(3):180–187PubMedCrossRefGoogle Scholar
  31. 31.
    Ryan BM, Kelleher D (2000) Refractory celiac disease. Gastroenterology 119(1):243–251PubMedCrossRefGoogle Scholar
  32. 32.
    Holmes GK (2002) Coeliac disease and malignancy. Dig Liver Dis 34(3):229–237PubMedCrossRefGoogle Scholar

Copyright information

© Royal Academy of Medicine in Ireland 2011

Authors and Affiliations

  • A. Saleem
    • 1
    • 2
  • H. J. O’. Connor
    • 1
  • P. O’. Regan
    • 3
  1. 1.Faculty of Health SciencesTrinity College, University of DublinDublinIreland
  2. 2.Department of Gastroenterology and HepatologyCork University Hospital, WiltonCorkRepublic of Ireland
  3. 3.South Tipperary General Hospital ClonmelClonmelIreland

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