Sa1323 Frequency of Celiac Disease Among Women With Reproductive Disorders

AIM. To assess the frequency and clinical presentation of celiac disease (CD) among women with reproductive disorders (RD) and to estimate the efficiency of influence of GFD in CD women with RD. MATERIALS AND METHODS: At the period from 2002 to 2011 we examined 217 women from gynecological-obstetrics departments. Age ranged from 16 to 72 years, the average age was 30,5± 5,8 years. The first stage of examination determined anti-TTG and main classes of immunoglobulin. The second stage women with high level of anti-TTG were undergone endoscopy examination with biopsy. The great attention was paid to careful data collection of gastroenterological symptoms in women with RD. CD diagnosis was based on duodenal biopsy. Results of intestinal biopsy were classified according to revised Marsh criteria 1999. The control group consisted of 15 healthy women. RESULTS: The majority of the patients (87,3%) had spontaneous abortions in anamnesis, infertility in 12.7% cases. The great attention was paid to careful data collection of gastrointestinal symptoms in women with RD. Established that the majority of patients had normal stool once or twice a day (89,8%), however, 18,5 % of the patients had diarrhea, 29,7%-constipation, 40,5% had bloating, 40%-weakness. The anti-tTG level ranged from 1 to 280 while 16 of them exceeded upper limit of normal level and averaged 50,2± 19.4. The anti-tTG level in patients of control group ranged from 0 to 10 and the average level 4,4 ±1,5. We compared gastroenterological symptoms in women with high level of anti-tTG and women with normal level of anti-tTG.Women with increased level of anti-tTG suffered from bloating75%(p<0,001), weakness-56,2%( p<0,001), diarrhea-68,7%( p<0,001). Therefore, these patients had every reason to diagnose CD. Biopsy was performed in 14 women with increased level of anti-tTG. We proved the CD diagnose by biopsy in 7 women (Marsh criteria 1999). Normal structure of the mucosa was revealed in 7 women. CD diagnosed in 7 women. Two women with miscarriages in anamnesis were pregnant. The anti-tTG level was 21,9 and 15,9. They were not offered esophagogastroscopy, however to avoid complications they were suggested to keep to GFD. After strict keeping to GFD they felt better, their gastrointestinal complaints disappeared, antibody level normalized. As a result they gave birth to healthy, full-term newborns. Three women did not strictly keep GFD, 2 women did not plan pregnancy. Two women after 8-12 months of strict keeping to GFD gave birth to healthy, full-term newborns. CONCLUSION. The frequency of CD among women with RD was 3,2%. Therefore celiac disease diagnostic procedures (serological screening) could be routinely performed in women with RD as a potential useful strategy to treat the same disorders and to allow for an early diagnosis of those all too often unrecognized cases of celiac disease.