Celiac disease may strike elderly, too

NEW YORK, 25 july2009- Celiac disease doesn't only affect the young, new research from Finland confirms, but can strike a person for the first time in later life.

In people with celiac disease, eating gluten-a protein found in many types of grain-causes the immune system to launch an attack on the small intestine. This can eventually damage the organ and lead to poor absorption of nutrients, especially fat. But people with celiac disease who cut gluten out of their diet can avoid symptoms and complications.

It's now possible to use blood tests to determine whether or not a person has celiac disease, which affects over 1% of Western populations, Dr. Anitta Vilppula of Päijät-Häme Central Hospital in Lahti and her colleagues note. In the United States, celiac disease is four times more common now than it was in the 1950s. (See Reuters Health eLine report, July 10, 2009.)

While people may think of the condition as a problem for children and young adults, they add, Vilppula and her team recently identified cases of celiac disease in elderly people. In some individuals, the condition had not been detected.

In the current study, the researchers investigated whether some older people had actually developed celiac disease later in their lives, or the disease had simply gone undetected. They looked at 2,815 people over 55 who had undergone blood tests for celiac disease in 2002, 2,216 of whom were screened again in 2005. The researchers also did biopsies of patients' small intestines to confirm the blood test findings.

In 2002, 2.13% of the study participants had biopsy-confirmed celiac disease, while 2.34% did in 2005. There were five new cases among people whose blood tests had initially been negative for the disease, and only two of these individuals had symptoms. That led the researchers to conclude that the elderly could develop the disease late in life.

Past research has shown that undetected celiac disease can lead to significant health problems in older people, the researchers note; in one study including 35 people 60 and older, 15 had been seeing their doctor for 28 years, on average, with symptoms without being diagnosed.

Doctors should be aware of the possibility that their older patients may have or develop celiac disease, Vilppula and colleagues say, and they should use blood tests to confirm the diagnosis-even though a negative test doesn't mean a person won't develop the condition later on.

SOURCE: BMC Gastroenterology, online June 29, 2009.