Screening of celiac disease in patients with osteoporosis and osteopenia

Česká verzia

Authors: P. Fojtík ¹; P. Novosad ²; M. Kliment ¹; P. Hrdý ²; Á. Bóday ³; R. Richterová ³; O. Urban ^1,4
Authors place of work: Centrum péče o zažívací trakt, Vítkovická nemocnice, a. s., Ostrava-Vítkovice, přednosta MUDr. Ondřej Urban, Ph. D. ¹; Osteologické centrum Mediekos Labor, a. s., Zlín, přednosta MUDr. Pavel Novosad ²; Laboratoř molekulární biologie, vedoucí RNDr. Radmila Richterová, P&R Lab, a. s., Nový Jičín, ředitelka RNDr. Magdalena Uvírová ³; Lékařská fakulta Ostravské univerzity Ostrava, děkan doc. MUDr. Arnošt Martínek, CSc. ⁴
Published in the journal: Vnitř Lék 2011; 57(12): 1000-1005
Category: 70th birthday of prof. MUDr. Petr Dítě, DrSc.

Summary

The celiac disease is traditionally viewed as the children’s disease with a typical form accompanied mainly by intestinal symptoms and malabsorption. This opinion is still generally accepted by the medical community. Findings based on the area-wide screening show that the prevalence has risen from the original 1 : 1 000–1 500 to 1 : 70–550. The average prevalence in the western countries is nearly 1 : 100. The prevalence of the celiac disease in the Czech republic is estimated to be approximately 1 : 200–250. It means that the number of people in the Czech republic who are likely to be affected is about 40,000–50,000 people. Currently only 10–15% of the total number of the ill people are diagnosed and monitored. Adult patients represent the main diagnostic problem because their clinical pictures are individual and the main symptoms are atypical (nonenteral). These are anaemia (mainly sideropnic), early/premature osteoporosis, herpetiformic (Duhring) dermatitis, polyneurititis, ataxia, depression, behavioural disorders, menstrual cycle disorders and infertility. Therefore our attention is currently focused on the screening of these groups of subjects. The purpose of our study was to check the frequency of the celiac disease with patients with diagnosed osteoporosis and osteopenia. In our study we have confirmed the assumption that the prevalence of the celiac disease in the group of subjects was 1 : 50, which means that 2.2% of patients with osteoporosis and osteopenia are affected by celiac sprue and therefore screening examination of these patients with the subsequent causal treatment (gluten-free diet) is recommended.

Key words:
celiac disease – targeted screening – risk groups and disease – osteoporosis – osteopenia – secondary osteoporosis

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