Vnitr Lek 2007, 53(12):1296-1302

Celiac disease - a frequent cause of "idiopathic osteoporosis" in premenopausal and early postmenopausal women

Ľ. Kubincová^1,*, J. Payer², Z. Killinger², I. Mačugová³, K. Beráková⁴

¹ Osteologická ambulancia Interného oddelenia, NsP Žilina, Slovenská republika, prednosta prim. MUDr. Vladimír Spišák

² V. interná klinika Lekárskej fakulty UK a FNsP Bratislava-Ružinov, Slovenská republika, prednosta prof. MUDr. Juraj Payer, CSc.

³ Gastrocentrum NsP Žilina, Slovenská republika, prednosta prim. MUDr. Peter Haupt

⁴ Patologicko-anatomické oddelenie NsP Čadca, Slovenská republika, prednostka prim. MUDr. Katarína Beráková

Introduction:
Celiac disease (CD) is an autoimmune disease with a wide variety of clinical symptoms. Osteopathy is its possible manifestation in adulthood.

Objective:
Verify the assumption, in view of contradictory literary data concerning serological screening for CD in osteoporosis, that the screened group could be women with idiopathic osteoporosis diagnosed in premenopause or within 5 years from its onset.


Patient sample and results:
We examined 52 patients with idiopathic osteoporosis detected by a DXA test of LS or the femur in premenopause or within the maximum of 5 years after menopause for the presence of antibodies against gliadins IgA, IgG, endomyzium IgA and transglutaminase IgG. In the case of positive results for any of the antibodies, we also performed gastrofibroscopy and duodenal biopsy. The positivity of antibodies was detected in 21 patients (40.8 %). In 15 (28.8 %) patients, i.e. after the exclusion of Marsh I in 10 patients (19.8 %), histopathology was positive for CD. Significantly higher levels of iPTH (p < 0.001) were detected in patients with CD. We did not find any statistically significant differences in other monitored parameters, i.e. in BMI, S-Ca, S-P, proteins, albumins, immunoglobins IgG, IgA, IgM, dUCa. The differences in the occurrence of prevalent fracture (33.4 or 19.8 %), autoimmune thyreoiditis (20 % or 5.4 %), anemia (33 % or 16.2 %) and dyspepsia (40 % or 24.3 %) were not significant.

Conclusion:
The above results confirm the need for serological screening for CD in premenopausal and early postmenopausal patients with "idiopathic osteoporosis".

Keywords: celiac disease; idiopathic osteoporosis; serological screening

Received: July 27, 2007; Accepted: September 16, 2007; Published: December 1, 2007  Show citation