Review Article

The Epidemiology of Celiac Disease in the General Population and High-Risk Groups in Arab Countries: A Systematic Review

Table 3

Clinical characteristics in clinically and laboratory CD-confirmed population.

S. no.Authors (year)CountryAimsStudy design/populationDiagnostic criteriaCase definitionNOS score

1Wafa’a Al-Qabandi et al. (2015) [44]KuwaitTo share the experience of dealing with Kuwaiti children suffering from celiac diseaseRetrospective research
47 patients of CD serology and biopsy proven (symptomatic: 25, screened: 22)
Age range from 7 to 189 months
EMA, AGA-IgA, AGA-IgG, and anti-tTG66% females, 34% males, 85% EMA positive, 79% AGA-IgA positive, and 77% AGA-IgG positive.
19 have T1D, 2 have Down’s syndrome, 1 has both T1D and Down’s syndrome, 3 have hypothyroidism, and 1 juvenile has idiopathic arthritis
9% had celiac disease family history.
6
2Saadah (2011) [45]Saudi ArabiaTo identify the clinical pattern of celiac disease prevalenceRetrospective, hospital-based researchAnti-tTG, IgA, IgG antibodies and biopsy proven80 children were diagnosed with celiac disease (age range of 0.5–18 years)
39 (49%) individuals showed conventional symptoms of malabsorption, while 41 (51%) were found to be at high risk of developing CD.

18 (23%) = positive IgG antibodies

11 out of 65 individuals showed disturbed liver function tests.
5
3Sarkhy et al. (2015) [46]Saudi ArabiaTo address clinical characteristics of celiac disease among Saudi children as well as to examine the adherence rate to gluten-free diet along with its determinant factorsCross-sectional study
113 children; median age 9.9 years
Biopsy-confirmed cases92% of the patients were symptomatic while 8% were asymptomatic.
Out of total, 62 of the children were females.
The most commonly presenting symptoms include poor weight gain (54%), chronic abdominal pain (59.3%), abdominal distention, gases, bloating (46.1%), and chronic diarrhea (41.6%).
Shorter duration since the diagnosis and younger age at diagnosis were interrelated with an improved adherence rate.
7
4Saeed et al. (2017) [47]Saudi ArabiaTo characterize the clinical presentations and diagnosis in children under the age of 18 with celiac disease at a private tertiary care health care center in RiyadhRetrospective study
59 children
IgA-tTG and IgG-tTG antibodies and biopsy50.8% males
Median age 8 years
Mean duration of symptoms before diagnosis 2.3 years (±1.5).
Classical disease was merely observed in 30.5%, while 69.5% had either nonclassical presentations or belonged to high-risk groups for celiac disease
91.5% positive for IgA-tTG antibodies
81.3% positive for IgG-tTG
52 had Marsh grade III lesion.
5

Abbreviation: IgA-tTG: antitissue transglutaminase IgA; IgG-tTG: antitissue transglutaminase IgG; EMA: antiendomysium antibodies; AGA: antigliadin antibodies; NOS: Newcastle-Ottawa Scale.