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Celiac disease in Middle Eastern and North African countries: a new burden?
Journal article   Open access   Peer reviewed

Celiac disease in Middle Eastern and North African countries: a new burden?

Kassem Barada, Abbas Bitar, Mohamad Abdul-Razak Mokadem, Jana Ghazi Hashash and Peter Green
World journal of gastroenterology : WJG, Vol.16(12), pp.1449-1457
03/28/2010
DOI: 10.3748/wjg.v16.i12.1449
PMCID: PMC2846249
PMID: 20333784
url
https://doi.org/10.3748/wjg.v16.i12.1449View
Published (Version of record) Open Access

Abstract

Celiac disease (CD) is now recognized as a common disorder among Middle Eastern (ME) and North African (NA) populations. The aim of this review is to assess the available data regarding CD in the ME and NA and to compare this information with that of Western countries. A literature review was performed using the electronic databases PubMed and Medline (1950-2008) as search engines, and "celiac disease" was used as a Mesh term. The search was limited to ME and NA countries. The prevalence of CD in ME and NA countries among low risk populations is similar to that of Western countries, but is higher in high risk populations such as those with type 1 diabetes. It is underestimated because of lack of clinical suspicion and lack of patient awareness. Clinical presentations in term of gastrointestinal, hematologic, skeletal, and liver manifestations are similar between both populations except for a high prevalence of short stature in some ME and NA countries. Few studies have addressed atypical or silent CD. As in the West, diagnosis is initially made by serological tests and is confirmed by small intestinal biopsies. Gluten-free diet is the main mode of treatment with a higher apparent adherence rate than in the West. Most disease complications result from malabsorption. The disease is strongly associated with HLA DQ2 and to a lesser extent with HLA DQ8 alleles. In conclusion, CD prevalence is underestimated, with little data available about its malignant complications. Disease parameters in the ME and NA are otherwise similar to those in Western countries.
 Predictive Value of Tests Genetic Predisposition to Disease Prevalence Risk Assessment Humans Risk Factors Treatment Outcome Celiac Disease - diagnosis Celiac Disease - etiology Young Adult Middle East - epidemiology Adolescent Adult Celiac Disease - epidemiology Developing Countries Africa, Northern - epidemiology Celiac Disease - diet therapy Child Diet, Gluten-Free

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