Celiac disease: Do not miss that diagnosis!

Abstract Background Celiac disease (CD) is a chronic autoimmune disorder induced in genetically susceptible individuals after ingestion of gluten proteins Aim of the work To highlight the utility of abdominal CT/enterography in diagnosis of CD. Subjects & methods This retrospective study included 12 patients presented to our institute during the period from May 2011 till April 2013 with vague abdominal symptoms, performed abdominal CT/enterography. The final diagnosis was reached in all patients through upper GI endoscopy, duodenal biopsy and serological tests including anti-tissue transglutaminase and anti-endomysial antibodies. Results The sensitivity of different CT signs was calculated against the diagnostic standard of reference (biopsy & serology). The jejuno-ileal fold reversal pattern was detected in 100% of patients. Other findings included (in descending order): Enlarged mesenteric lymph nodes in eight patients (66.5%); jejunal wall thickening, dilated jejunal loops, and cavitating lymph nodes in six patients (50%); dilated ileal loops in four patients (33%); ileal wall thickening in three patients (25%); thickened duodenum, and small bowel intussusception in two patients (16.5%). Conclusions CT is an efficient imaging tool in diagnosis of CD. The jejuno-ileal fold reversal pattern is highly in favor of the diagnosis of CD.