Adult coeliac disease in South Africa. An analysis of 20 cases emphasizing atypical presentations
Kavin, H.
South African Medical Journal 59(18): 628-632
1981
ISSN/ISBN: 0256-9574 PMID: 7221782 Document Number: 179837
This is the 1st comprehensive report of celiac disease from South Africa. Twenty patients with adult celiac disease diagnosed in Johannesburg between 1966-1978 are reviewed. A significant number apparently did not present with the classic features of the disease. Secondary nutritional manifestations were frequently absent and were possibly masked in some patients by self-medication or by the prescription of vitamins and hematinics before the diagnosis was made. The majority of patients were from the middle or upper socioeconomic class and few complained of anorexia, nausea, vomiting or abdominal pain. Many (patients) probably maintained an adequate intake of nutrients throughout the course of their illness. The severity of diarrhea and steatorrhea did not correlate with the state of nutrition of the patients as assessed by a variety of blood studies. Megacolon, present in 2 patients, responded to a gluten-free diet. An interesting observation was that patients diagnosed after the age of 40 yr had been symptomatic for a much shorter time period than younger patients.