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Objective. Gluten intolerance is a common, immunologically mediated disorder with a widely variable clinical presentation that affects genetically predispose d subjects. Women seem to be more frequently affected although data on sex diffe rences are poor. In this study the prevalence of different clinical pictures acc ording to sex and age is analysed in a large series of patients. Material and me thods. A total of 1436 patients with gluten intolerance were retrospectively con sidered, diagnosed from January 1975 to August 2001 based on compatible small- bowel biopsy and response to a gluten- free diet, plus immunofluorescent detection of granula r IgA in papillary derma for dermatitis herpetiformis. The clinical picture at o nset (classic, non- classic, silent) and age at diagnosis (≤ 2 years,>2 and ≤ 14 years,>14 years) was recorded; 362 parents of coeliac probands undergoing a familial screening were also studied. The relations among sex, age class and symptoms were analysed using the χ 2 test with Yates’ s correction. Results. T he overall female/male ratio was 2.3∶ 1 but the inter- sex difference was sign ificant only when the diagnosis was made in adulthood where a significant associ ation between iron- deficiency anaemia as manifestation at onset in adult women (34% versus 7% )was found. Lowweight, dyspepsia and hypertransaminasaemia we re more common in adult men than women (20% , 14% and 7% versus 13% , 3% and 2% , respectively). Dermatitis herpetiformis was present more frequently in men (16% versus 9% ). The prevalence of silent cases was 6% in men and 3% in women. Familial screening showed the same prevalence (9.3% ) of current co eliac disease in fathers and mothers. Conclusions. Diagnosis of coeliac disease is more frequent in women but physicians’ awareness of sex- and age- relate d differences in clinical presentation could improve diagnostic performances in men.
Objective. Gluten intolerance is a common, immunologically mediated disorder with a widely variable clinical presentation that affects genetically predispose d subjects. Women seem to be more frequently affected although data on sex diffe rences are poor. In this study the prevalence of different clinical pictures acc ording to sex and age is analyzed in a large series of patients. Material and me thods. A total of 1436 patients with gluten intolerance were retrospectively con-sidered, diagnosed from January 1975 to August 2001 based on compatible small- bowel biopsy and response to a gluten- free diet, plus immunofluorescent detection of granula r IgA in papillary derma for dermatitis herpetiformis. The clinical picture at o nset (classic, non-classic, silent) and age at diagnosis (≤ 2 years,> 2 and ≤ 14 years, > 14 years) was recorded; 362 parents of coeliac probands undergoing a familial screening were also studied. The relations among sex, age class and symptoms were analysed usi ng the χ 2 test with Yates’ correction. Results. T he overall female / male ratio was 2.3: 1 but the inter-sex difference was significant only when the diagnosis was made in adulthood where a significant assocition between iron- deficiency anaemia as manifestation at onset in adult women (34% versus 7%) was found. Lowweight, dyspepsia and hypertransaminasaemia we re more common in adult men than women (20%, 14% and 7% versus 13%, 3% and 2% , respectively). Dermatitis herpetiformis was present more frequently in men (16% versus 9%). The prevalence of silent cases was 6% in men and 3% in women. Familial screening showed the same prevalence (9.3%) of current co eliac disease in fathers and mothers. Conclusions. Diagnosis of coeliac disease is more frequent in women but physicians’ awareness of sex- and age-relate d differences in clinical presentation could improve diagnostic performances in men.