Is it necessary to screen for celiac disease in adult idiopathic osteoporosis?

ABSTRACT

The aim of this study was to investigate the necessity of screening for celiac disease in idiopathic osteoporotic patients. Osteopenia and osteoporosis are well-known and prevalent complications of celiac disease. However, the relative prevalence of celiac disease among osteoporotic populations is not known, and the benefit of screening for celiac disease among the osteoporotic population remains controversial. We evaluated a total of 560 individuals, 460 with osteoporosis and 100 healthy subjects, from the rheumatology clinic in Imam Khomeini and Shariati hospital by IgA anti-tissue transglutaminase [anti-tTG] for celiac disease. Then individuals with positive serologic test underwent upper GI Endoscopy and 2nd part duodenum biopsies. The clinical findings were evaluated in both groups and were compared with each other. Five [1.08%] of 460 patients with osteoporosis and 1 [1%] of 100 subjects without osteoporosis had celiac disease by positive serologic and pathology results. Three patients with positive serology and pathology results were female. All patients in osteoporotic group had at least one other symptom of celiac disease. Two of them had anemia and others had chronic abdominal pain, recurrent oral aphtous lesion and chronic bloating. In the present study, the prevalence of celiac disease in osteoporotic patients is not high enough to justify recommendation for serologic screening of celiac disease in all patients with idiopathic osteoporosis; but in osteoporotic patients with other celiac or gastrointestinal symptoms and signs, for example iron deficiency anemia, chronic dyspepsia and bloating, constipation or diarrhea and recurrent aphtous lesions, it is necessary to evaluate for celiac disease