ABSTRACT
Celiac disease [CD] is an autoimmune disorder characterized by gluten sensitivity in genetically susceptible individuals. There is no previous report on CD and Toxoplasma gondii infection and no previous assessments with regard to the association of these conditions on pregnancy. The aim of this study was to estimate the prevalence of undiagnosed CD and T.gondii in the pregnant women. In this descriptive study, during the period of January-July 2007, 496 pregnant women with mean age of 26 +/- 5 years [SD 4.11] and mean pregnancy duration 5.2 months were referred to reproduction section of rural and urban health care centers in Lorestan province. They underwent a total IgA test and antihuman IgA class antitissue transglutaminase [tTGA] antibodies for detection of CD. Those with IgA deficiency were tested with IgG tTG. Also IgG and IgM-Toxoplasma level were measured for detection of total antibody against T.gondii. Of 496 pregnant women, 13 [2.6%] had a positive CD serology for tTGA [95% CI: 1.2%-4.3%]. 154/496 patients had IgG positive test and 35/154 patients had IgM positive for T.gondii indicating acute stage of T.gondii infection. It is well established that CD and T.gondii infection are both associated with a high incidence of unfavorable outcomes in pregnancy. Our data suggest that CD may predispose to the development of T.gondii infection
ABSTRACT
The screening of patients with dyspepsia, may allow an early identification of affected individuals. The aim of this study was to determine the prevalence of celiac disease in dyspeptic patients submitted to routine diagnostic upper gastrointestinal endoscopy. From November 2007 to October 2008, 407 patients who underwent endoscopy for any reason [193 male, 214 women; mean age36.1 years] were studied in this work. Histological characteristics in duodenal biopsy specimens for celiac disease were evaluated according to the modified Marsh Classification1999. In addition, all patients were tested for total immunoglobulin A and antitransglutaminase [tTG] antibodies. The patients with IgA deficiency were tested with IgG tTG. Duodenal histology showed the malabsorption pattern [Marsh I-IIIc] in 26 [6.4%] cases and 33 cases had serological positive test for tTGA. In term of the serological analysis, 10 out of 33 tTGA positive patients had malabsorption pattern [Marsh I,-IIIc], and all of them had a positive tTGA [2.45%]. Four of the 407 recruited patients were IgA deficient and none of them were positive for IgG tTG. In this study, about 6.4% of patients had malabsorption pattern and 8.1% presented with positive serology for CD. However, both histology and serology were positive in 10/407 [2.45%]. The high prevalence of celiac among dyspeptic symptomatic individuals indicates that they are a higher risk group for developing celiac disease