Upper gastrointestinal endoscopic findings in celiac disease at diagnosis: A multicenter international retrospective study

Table 1 Demography, celiac disease serology, and endoscopic findings by cohorts and the overall population

Demographic data and upper GI endoscopic findings	Naples/Salerno cohort	Buenos Aires cohort	Hamilton cohort	Padua cohort	Overall CeD population
Total population	930 (70.0)	97 (7.3)	167 (12.6)	134 (10.1)	1328
Age in yr	34 (26-42)	35 (27-44)	39 (27-54)	35 (23-46)	35 (26-43)
Female sex	754 (81.1)	88 (90.7)	122 (73.0)	100 (74.6)	1064 (80.1)
Patients with positive serology	899 (96.7)	97 (100)	147 (88.0)	130 (97.0)	1269 (95.6)
Patients with at least one significant endoscopic abnormality	89 (9.6)	8 (8.2)	34 (20.4)	4 (3.0)	135 (10.2)
Reflux esophagitis with erosions	78 (8.4)	1 (1.0)	6 (3.6)	0	85 (6.4)
Esophageal peptic ulcers	0	0	1 (0.6)	0	1 (0.2)
Esophageal malignancy	0	0	0	0	0
Suspicion of esophageal metaplasia	3 (0.3)	0	13 (7.8)	0	16 (1.2)
Biopsy confirmed Barrett’s esophagus	2 (0.2)	0	1(0.6)	0	3 (0.2)
Gastric erosions	0	7 (7.2)	16 (9.6)	4 (3.0)	27 (2.0)
Gastric ulcers	1 (0.1)	0	0	0	1 (0.1)
Gastric cancer	0	0	0	0	0
Duodenal erosions	0	0	15 (9.0)	0	15 (1.1)
Duodenal ulcers	8 (0.9)	1 (1.0)	6 (3.6)	0	15 (1.1)
Duodenal cancer	0	0	0	0	0

Data are presented as n (%) or median and 25% interquartile range. CeD: Celiac disease; GI: Gastrointestinal; IQR: Interquartile range.

Table 2 Demography, celiac disease serology, and endoscopic findings of the overall population and by the age of diagnosis

Demographic data and upper GI endoscopic findings	Overall CeD population	≤ 50 yr	51-60 yr	≥ 61 yr
Patients	1328	1140 (85.8)	114 (8.6)	74 (5.6)
Age in yr	35 (26-43)	33 (25-39)	55 (53-56)	67 (63-71)
Female sex	1064 (80.1)	931 (81.7)	82 (71.9)	51 (41.0)
Patients with positive serology	1269 (95.6)	1092 (95.8)	109 (95.6)	68 (91.9)
Patients with at least one significant endoscopic abnormalities	135 (10.1)	102 (8.9)1	20 (17.5)	13 (17.6)
Reflux esophagitis with erosions	85 (6.4)	69 (6.0)	12 (10.5)	4 (5.4)
Esophageal ulcers	1 (0.2)	1 (0.1)	0	0
Esophageal cancer	0	0	0	0
Suspicion of metaplasia	16 (1.2)	10 (0.9)	3 (2.6)	2 (2.7)
Biopsy confirmed Barrett’s esophagus	3 (0.2)	2 (0.2)	0	1 (1.3)
Gastric erosions	27 (2.0)	20 (1.7)	3 (2.6)	4 (5.4)
Gastric ulcers	1 (0.1)	1 (0.1)	0	0
Gastric cancer	0	0	0	0
Duodenal erosions	15 (1.1)	8 (0.7)	3 (2.6)	4 (5.4)
Duodenal ulcers	15 (1.1)	10 (0.9)	4 (3.5)	1 (1.3)
Duodenal cancer	0	0	0	0

¹≤ 50-years-old vs other age categorizations: vs patients > 51-years-old: P < 0.01. Data are presented as n (%) or median and 25% interquartile range.

CeD: Celiac disease; GI: Gastrointestinal.

Table 3 Demography and endoscopic findings in celiac disease patients and non-celiac disease controls of the Buenos Aires cohort

Demographic data and upper GI endoscopic findings	CeD population	Non-CeD population	≤ 50 yr non-CeD	51-60 yr non-CeD	≥ 61 yr non-CeD
Patients	97 (12.6)	674 (87.4)	435 (64.5)	135 (20.0)	104 (15.4)
Age in yr	35 (27-44)	45 (33-55)a	37 (29-44)	55 (53-58)	68 (63-72)
Female sex	88 (90.7)	472 (70.0)a	312 (71.7)	92 (68.1)	68 (65.4)
Patients with positive serology	97 (100)	9 (1.3)a	6 (1.3)	3 (2.2)	0
Patients with at least one significant endoscopic abnormalities	8 (8.2)	196 (29.1)b	121 (27.8)	48 (35.6)	27 (26.0)
Reflux esophagitis with erosions	1 (1.0)	21 (3.1)	11 (2.5)	2 (1.5)	5 (4.8)
Esophageal ulcers	0	0	0	0	0
Esophageal cancer	0	0	0	0	0
Suspicion of metaplasia	0	7 (1.0)	5 (1.1)	2 (1.5)	0
Biopsy confirmed Barrett's esophagus	0	2 (0.3)	2 (0.5)	0	0
Gastric erosions	7 (7.22)	165 (24.5)a	103 (23.7)	43 (31.8)	19 (18.3)
Gastric ulcers	0 (0)	11 (1.6)	4(0.9)	2 (1.5)	5 (4.8)
Gastric cancer	0	2 (0.3)	0	1 (0.7)	1 (1.0)
Duodenal erosions	0	10 (1.5)	6 (1.4)	2 (1.5)	2 (1.9)
Duodenal ulcers	1 (1.0)	5 (0.7)	2 (0.5)	2 (1.5)	1 (1.0)
Duodenal cancer	0	1 (0.1)	1 (0.2)	0	0

^aP < 0.01.

^bP < 0.001.

Data are presented as n (%) or median and 25% interquartile range. Controls were grouped according to age at endoscopy. Comparisons between celiac disease patients vs non-celiac disease controls.

CeD: Celiac disease; GI: Gastrointestinal; IQR: Interquartile range.

Table 4 Crude and adjusted multivariate analysis for the Buenos Aires cohort

Independent variable	At least one endoscopic lesion1 (Buenos Aires cohort)
	OR (95%CI)	P value	Adjusted2 OR (95%CI)	P value
Male sex	1.19 (0.83-1.69)	0.34	1.03 (0.72-1.48)	0.860
Age	1.01 (1.00-1.02)	0.14	1.00 (0.99-1.01)	0.550
Celiac disease	0.22 (0.10-0.46)	< 0.0001	0.28 (0.13-0.60)	0.001
Alarm symptoms3	0.51 (0.35-0.74)	< 0.0001	0.63 (0.43-0.93)	0.020

¹At least one endoscopic lesion: Erosive esophagitis, esophageal ulcer, esophageal cancer, Barrett’s esophagus, gastric erosion, gastric ulcer, gastric cancer, duodenal erosion, duodenal ulcer, duodenal cancer.

²Weight loss, anemia, bleeding, dysphagia, epigastric pain, neoplasia history.

³Weight loss, iron deficient anemia, malabsorption, chronic diarrhea.

CI: Confidence interval; M: Male; OR: Odds ratio.