Retrospective study of celiac disease in Benghazi medical centre from first of June 2021 up to 30th of June 2024

Abstract

Celiac disease (CD) is an autoimmune disorder triggered by an abnormal immune response to gluten in genetically predisposed individuals, influenced by both genetic and environmental factors. It affects approximately 1% of the general population, although the prevalence is notably higher among individuals with other autoimmune diseases, such as diabetes mellitus. Patients with celiac disease may present with a broad spectrum of symptoms, ranging from classical gastrointestinal manifestations to extra-intestinal features.

This retrospective study was conducted to analyze the demographic distribution, common clinical manifestations, diagnostic classifications based on Marsh criteria, association with other autoimmune conditions, and adherence to treatment among celiac disease patients. The study also aimed to identify the relationship between celiac disease, anemia, and coexisting autoimmune disorders, as well as to determine the most common Marsh classification observed in cases with gastrointestinal symptoms.

The study included 61 patients diagnosed with celiac disease who presented to Benghazi Medical Center between June 1, 2021, and June 30, 2024. The patients’ ages ranged from 11 to 69 years, with a predominance of females (47 out of 61 cases). Data were collected retrospectively from patients’ medical records and included gender, clinical presentation, diagnostic classification, associated autoimmune diseases, and treatment adherence.

The most frequently reported symptoms were diarrhea (52.5%), followed by abdominal pain (27.1%), weight loss (20.3%), vomiting (18.6%), and anemia (22%). Laboratory investigations revealed that 34 patients had low hemoglobin levels, 37 exhibited vitamin D deficiency, and 18 had reduced calcium concentrations. Among the associated autoimmune conditions, hypothyroidism was the most common (8 cases), followed by hyperthyroidism (4 cases), diabetes mellitus (6 cases), and isolated cases of thyroiditis and rheumatoid arthritis. Additionally, 4 patients had a history of liver disease. Based on the Marsh classification, Type I was the most prevalent, followed by Type IIIa.

In conclusion, the findings indicate a higher prevalence of celiac disease among females compared to males. Diarrhea was the predominant symptom, accompanied by other gastrointestinal and systemic manifestations such as abdominal pain, weight loss, vomiting, and anemia. Vitamin D deficiency represented the most common laboratory abnormality, followed by anemia and hypocalcemia. The coexistence of hypothyroidism and diabetes mellitus highlights the autoimmune nature of the disease. Marsh Type I lesions were most frequently observed, with a considerable number of patients responding positively to a gluten-free diet, although a minority exhibited poor dietary response. Overall, the study emphasizes the importance of early diagnosis and dietary management to improve clinical outcomes and prevent complications associated with celiac disease.