Celiac Disease in Sabzevar: Prevalence Patterns and Clinical Manifestations

Malakouti, Katayoun; Navipour, Elham; Ebrahimi, Mohammad Amin; Khatib, Ali; Rastisani, Morteza; Aldaghi, Mithra Azra

doi:10.22038/jpp.2026.96272.5679

Celiac Disease in Sabzevar: Prevalence Patterns and Clinical Manifestations

Document Type : original article

Authors

Katayoun Malakouti ¹

Elham Navipour ²

Mohammad Amin Ebrahimi ¹

Ali Khatib ³

Morteza Rastisani ⁴

Mithra Azra Aldaghi ⁵

¹ Student Research Committee of Sabzevar University of Medical Sciences, Sabzevar, Iran.

² Department of Community Medicine, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.

³ Nursing Student, Neyshabur University of Medical Sciences, Neyshabur, Iran.

⁴ Department of Pediatric Neonatology, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.

⁵ Department of Pediatric Gastroenterology, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.

10.22038/jpp.2026.96272.5679

Abstract

Background: Celiac disease is a systemic immune-mediated disorder that develops in genetically predisposed individuals following the consumption of gluten and prolamin proteins found in wheat and barley. Considering the wide range of clinical presentations of celiac disease and its association with other autoimmune disorders, and given the lack of sufficient data regarding its clinical spectrum, this applied research was conducted to assess the prevalence and clinical manifestations of celiac disease. This study aimed to determine the prevalence and clinical manifestations of CD in Sabzevar County, Iran.
Methods: This cross-sectional study reviewed the medical records of 2,000 patients referred to Heshmatieh Hospital in Sabzevar. Patients with symptoms suggestive of CD or with type 1 diabetes underwent serological testing (anti-tTG, total IgA). Those with positive serology underwent duodenal biopsy, classified according to the Marsh criteria. Demographic and clinical data were analyzed using SPSS.
Results: The prevalence of celiac disease was 2.7%. The mean age was 10.09 years (SD = 3.24), and 64.8% were female. Growth disturbances were the most common manifestation (59.2%), followed by diabetes-related symptoms (29.6%). Gastrointestinal symptoms were present in only 14.8%. Mean anti-tTG IgA titer was 194.03 IU/dL (SD=168.6), and higher titers correlated with more advanced Marsh grades (Marsh 3C: 281.52 IU/dL).
Conclusion: Celiac Disease demonstrates a considerable prevalence of 2.7% within this high-risk pediatric population in Sabzevar. These findings highlight the critical need for heightened physician awareness of extraintestinal manifestations to facilitate earlier diagnosis and effective management.

Keywords

Anti-tissue transglutaminase

Celiac disease

Iran

Marsh classification

Prevalence

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