Section 5 Complications

**69**

**Chapter 5**

**Abstract**

**1. Introduction**

10–40 years [4].

*Rakhshinda Jabeen*

and complications of celiac disease can be spared.

which make CD to diagnose late [5] (**Table 1**).

**Keywords:** complications, anemia, bone loss, cancers

Complications of Celiac Disease

Celiac disease is a small bowel disorder, due to defect in gluten diet, leading to mucosal inflammation, villous atrophy and crypt hyperplasia. For the diagnosis of celiac disease, one has to be on gluten free diet. Due to commonly available various serologic tests and histopathology, celiac disease, can be categorized as asymptomatic, silent or potential. Between 80 and 90% of all patients with celiac disease remained undiagnosed. Because of this late diagnosis, patients may develop various complications including anemia, bone loss, depression and cancers. Patients may have different types of anemia including iron deficiency, folic acid or B12 deficiency. Any of these may occurred separately or may be manifested together. The same variation is seen in bone loss, starting from osteopenia, osteomalacia to osteoporosis and even dysplasias. Patient may develop lymphoma, gastric or oesophageal carcinomas as well. Celiac disease is also associated with other autoimmune illnesses as it is an autoimmune process by itself. The complications of celiac disease, is either due to direct consequence of celiac, or due to significant damage to the small intestine. With the early detection and diagnosis, the symptomatology

Celiac disease (CD) is one of the commonest malabsorptive syndromes, of either one or more nutrients. It was historically known as a disease of whites, but in recent era, it is as commonly seen in other parts of the world, including Asian and African countries [1, 2]. Because of its various categories starting from full blown CD, to completely asymptomatic variety, the clinical presentation dispersed among individuals. Although the commonest presentation is the gastrointestinal manifestation but many individuals may present with malignancies associated with CD. The logical answer for this diverse and late manifestation may be due to prolonged breast feeding and late commencement of gluten diet among infants, which was the usual presenting age among infants [3]. The usual age of presentation of CD now is

In recent days, young patients still presenting with classical symptoms of CD, i.e. gastrointestinal, although may have complications at the time of initial presentation. The older individuals usually present with complications of different varieties,

Among different categories of CD, including classical CD, atypical CD, asymp-

Classical celiac disease: The classical one, including three features: villous atrophy, symptoms of malabsorption and resolution of symptoms with gluten free diet.

tomatic and latent CD the presentation are different and thus complications.
