Celiac disease in osteoporotic Indians

Area of Science:

• Gastroenterology
• Endocrinology
• Bone Metabolism

Background:

• Osteoporosis affects a significant portion of the population, with atypical presentations requiring further investigation.
• Celiac disease (CD) is an autoimmune disorder often associated with malabsorption and extraintestinal manifestations.
• Early diagnosis and management of CD can prevent long-term complications.

Purpose of the Study:

• To identify atypical celiac disease (CD) in symptomatic osteoporotic patients under 55.
• To analyze clinical and laboratory features associated with CD in this cohort.
• To evaluate the outcomes of a gluten-free diet (GFD) in these patients.

Main Methods:

• 33 osteoporotic patients (<55 years) underwent serological screening for CD (IgA antibodies to tissue transglutaminase).
• Positive cases were confirmed via duodenal biopsy and histological analysis.
• Comprehensive laboratory tests (hemogram, calcium, vitamin D, PTH) were performed.

Main Results:

• 13 patients tested positive for CD antibodies; 11 were confirmed by biopsy, showing villous atrophy.
• CD patients exhibited significant anemia, low serum calcium and phosphorus, low 25-OH-D, and high PTH.
• A gluten-free diet (GFD) led to significant clinical and laboratory improvements within 6-12 weeks.

Conclusions:

• Symptomatic osteoporotic patients under 55, especially those with anemia, should be screened for celiac disease (CD).
• Diagnosis of CD in osteoporotic individuals warrants a trial of a gluten-free diet (GFD).
• GFD intervention rapidly improves clinical and laboratory parameters in CD patients.