P630. Inflammatory bowel disease in celiac patients
A. Hernandez Camba1, I. Alonso1, N. Hernandez Alvarez-Buylla1, M. Carrillo1, L. Ramos1, E. Quintero1, 1Hospital Universitario de Canaris, Gastroenterology, La Laguna, Spain
Several previous series and case reports have suggested an association between celiac disease and inflammatory bowel disease (IBD).
Increasing evidence suggest genetic similarities in both pathologies related to common inflammatory cytokines. In Spain the estimated prevalence to IBS is around 0.07%. The aim of this study is to analyze the prevalence of IBD in a cohort of patients with celiac disease.
A database of patients with celiac disease attended between January 2008 and May 2012 was analyzed. Only biopsy-proven adults were included and levels of anti-gliadine and anti-tissue transglutaminase antibodies were collected. Patients who had endoscopic and pathologic evidence of IBD were identified, and their medical records were reviewed.
Among 91 patients with celiac disease, IBD was identified in 4 (4.4%) with 3 cases of Crohn's disease and 1 case of ulcerative colitis (3F/1M, mean age 38 years). The prevalence observed was 4.4% and a relative risk of 50 (95% CI: 0–100). In 3 cases celiac disease was detected the same year of IBD diagnosis. One patient was diagnosed of celiac disease after 10 years suffering ulcerative colitis following neurologic manifestations (ataxia). All but 1 case had positive antibodies for celiac disease at diagnosis showing negative levels after gluten free diet. Maintaining treatment for IBD with mesalazine was used in 3 cases but 1 Crohn's disease patient required anti-TNF agents (adalimumab) during outcome.
The prevalence of inflammatory bowel disease in our serie of celiac patients was 4.4% and it was significantly more common than in the general population in Spain. We should consider a concomitant diagnosis when evaluate a patient with abdominal pain and diarrhoea in the gastroenterology survey.