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THE CHANGING CLINICAL PRESENTATION OF COELIAC DISEASE IN ADULTS
Author(s) -
Campbell C. Bryan,
Roberts Roderick K.,
Cowen Alistair E.
Publication year - 1977
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1977.tb130530.x
Subject(s) - coeliac disease , presentation (obstetrics) , medicine , disease , surgery
A diagnosis of coeliac disease was confirmed in 57 patients referred to a gastroenterology clinic over a 5$$1/2‐year period. Although diarrhoea was present in two‐thirds of the patients, this was the major symptom leading to referral in less than half of them. When present, diarrhoea was usually intermittent and frquently not typical of steatorrhoea. Symptoms were of less than six months’ duration in half the patients, but a review of the past and family history strongly indicated the possibility of coeliac disease in 39 of the 57 patients. A high spontaneous abortion rate during pregnancy was noted. The frequent absence of the classical features of malabsorption, diarrhoea with typical steatorrhoea and chronic debility was noted. All screening tests for malabsorption were found to be unreliable and their routine use was rarely justified. A random serum folate and carotene assay proved as valuable as more expensive and troublesome tests. It is stressed that in any case in which there is a clinical suspicion of this diagnosis, a small intestinal biopsy should be undertaken.