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[Celiac disease in the elderly: a case report].

Fiorenzo Baroni1, Maria Karin Ghisla, Roberto Leonardi

  • 1Cattedra di Medicina Interna II, Università degli Studi di Brescia. mkghisla@libero.it

Annali Italiani Di Medicina Interna : Organo Ufficiale Della Societa Italiana Di Medicina Interna
|April 14, 2006
PubMed
Summary

Celiac disease often presents subtly in older adults, with atypical symptoms. Early diagnosis and a gluten-free diet are crucial for managing this malabsorption condition in the elderly.

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Area of Science:

  • Gastroenterology
  • Geriatrics
  • Immunology

Background:

  • Celiac disease is an autoimmune disorder triggered by gluten ingestion.
  • It commonly causes malabsorption, but presentation in the elderly is often atypical and subtle.
  • Extraintestinal symptoms are prevalent, complicating diagnosis in older populations.

Observation:

  • A 73-year-old woman presented with non-specific symptoms including hyporexia, weight loss, depression, and functional decline.
  • Serological markers (antigliadin and antiendomysial antibodies) were positive.
  • Small intestinal biopsy revealed subtotal villous atrophy, increased intraepithelial lymphocytes, and hyperplastic glands (Marsh III).

Findings:

  • The patient's clinical presentation and biopsy results were consistent with celiac disease.

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  • The subtle, paucisymptomatic course in this elderly patient highlights diagnostic challenges.
  • Gluten-free diet was initiated as the primary therapeutic intervention.

    • Implications:

    • Highlights the importance of considering celiac disease in the elderly, even with atypical symptoms.
    • Emphasizes the role of serological testing and duodenal biopsy in diagnosis.
    • Underscores the effectiveness of a gluten-free diet in managing celiac disease in older adults.