Clinical Spectrum of Biopsy-Defined Celiac Disease in the Elderly

Thirty patients (17 females and 13 males) with adult celiac disease initially diagnosed after age 60 were seen during a 12-year period. Diagnosis in each patient was based on small intestinal biopsy and a clinical as well as histological response to a strict gluten-free diet. Diarrhea, weight loss and/or anemia, usually due to iron deficiency, were present in the majority of patients and often lead to other diagnostic considerations, including colon cancer, prior to definition of celiac disease. No patient in this series had a known family history of celiac disease. Dermatitis herpetiformis and thyroid hypofunction were frequently detected in this elderly population, possibly reflecting the autoimmune and systemic nature of celiac disease. Neoplastic disease was common in this age group, suggesting that particular vigilance in follow-up is required, especially for lymphoma, in elderly patients with celiac disease