Celiac sprue among US military veterans - Associated disorders and clinical manifestations

The present study aimed to describe the clinical manifestations of celiac s prue related to malnutrition and to analyze the associations between celiac sprue and other diagnoses. A case-control study compared the occurrence of comorbid diagnoses in case and control subjects with and without celiac sp rue, respectively. All patients with a primary or secondary diagnosis of ce liac sprue (ICD-579.0) who were discharged from hospitals of the Department of Veterans Affairs between 1986 and 1995 were selected as case subjects. In a multivariate logistic regression analysis, the occurrence of celiac di sease served as outcome variable, while age, gender, ethnicity, and the com orbid occurrences of other diagnoses served as predictor variables. A total of 458 individual patients with celiac sprue were identified. The data con firmed the known associations of celiac sprue with dermatitis herpetiformis , lactase deficiency, enlargement of lymph nodes, and lymphoma. Celiac spru e was also found to be statistically significantly associated with pancreat ic insufficiency, Crohn's disease, functional bowel symptoms, chronic nonal coholic hepatitis, and pulmonary eosinophilia. The nutritional manifestatio ns associated with celiac disease included nutritional marasmus, cachexia, weight loss, hypocalcemia, osteoporosis, vitamin B-complex deficiency, and various types of iron- and vitamin-deficiency anemias. The large variety of complex associations clearly indicates that celiac sprue is a systemic dis ease that involves multiple organs and exceeds an isolated nutritional into lerance to gluten.