The first report on the association of celiac disease and cystic fibrosis in a tertiary care center in Saudi Arabia

Hanaa Banjar; Ahmed Bawazir; Firas Ghomraoui; Khalid Alotaibi; Abduallah Alotaibi; Sarah Alotaibi; Reham Sayyari; Khalid Alsaleem

doi:10.1016/j.ijpam.2021.05.001

The first report on the association of celiac disease and cystic fibrosis in a tertiary care center in Saudi Arabia

Int J Pediatr Adolesc Med. 2022 Mar;9(1):56-61. doi: 10.1016/j.ijpam.2021.05.001. Epub 2021 May 31.

Authors

Hanaa Banjar¹, Ahmed Bawazir², Firas Ghomraoui³, Khalid Alotaibi¹, Abduallah Alotaibi¹, Sarah Alotaibi⁴, Reham Sayyari¹, Khalid Alsaleem¹

Affiliations

¹ Department of Pediatrics, King Faisal Specialist Hospital and Research Center (KFSHRC), Riyadh, Saudi Arabia.
² College of Medicine, Al-Faisal University, Riyadh, Saudi Arabia.
³ University at Buffalo- Catholic Health, 955 Main St, Buffalo, Newyork, USA.
⁴ Department of Otolaryngology- Head & Neck Surgery, (KFSHRC), Riyadh, Saudi Arabia.

Abstract

Introduction: Celiac disease (CD) has been described before in Saudi Arabia (SA) to be at the range of 1%-2% in the general population, but the association of celiac disease and cystic fibrosis (CF) has never been described before in the Middle East.

Objectives: To describe the prevalence of the association of CD and CF in patients with gastrointestinal symptomatology in a tertiary care center.

Method: ology: A retrospective charts review of all confirmed CD and CF patients for the years 1989-2018.

Results: In a total of 391 confirmed CF patients, 74 of them (19%) had celiac screening due to their symptomatology in the form of (abdominal pain and distension, vomiting, diarrhea despite adequate pancreatic enzyme replacements, and had high antigliadin antibodies and anti-transglutaminase IgA (tTGA). Thirty-five of the 74 patients were male (47.3%, and 39 (52.7%) were female patients. The mean age at diagnosis of CD was 6.1 (3.9), and the mean age at follow up was 7 (5 years). Only 2 of the 74 patients (3%) had bowel biopsies with the typical pathological findings of CD with villous atrophy. Both patients were placed on a gluten-free diet and showed marked improvement in symptomatology and weight gain.

Conclusion: CD screening should be considered in all CF patients despite the absence of symptoms. The prevalence of CD in CF patients in SA is similar to or slightly higher than that of the general population. A further study to screen the whole CF population is needed to delineate the actual prevalence, particularly in nonsymptomatic CF.

Keywords: Arabs; CFTR; Celiac disease; Cystic fibrosis.