Celiac Disease in Gonbad-Kavoos

Northeast Iran has one of the highest rates of esophageal cancer in the world which is mainly squamous cell carcinoma (E SCC). Celiac disease (CD) has been identified as a risk factor for ESCC. The aim of this study is to determine the prevalence of CD in Gonbad at northeast Iran and probable relation between celiac and ESCC. fourteen hundred inhabitants of north eastern Iran were randomly selected. The subjects underwent blood sampling for determination of IgA antibodies against tissue transglutaminase (anti-TTG). Subjects with positive anti-TTG underwent an interview, upper endoscopy and duodenal biopsy. The duodenal biopsies were classified according to Marsh criteria. A total of 1209 subjects (female: 699) with mean age of 50±11.7 years were studied. Twelve subjects (female: 9) had a positive anti-TTG (1%). Four patients did not accept endoscopy. Eight cases underwent endoscopy and duodenal biopsy. Four, two and two subjects had Marsh III, II and I respectively. Flatulence and diarrhea (the most symptoms) were in five and four subjects and characteristic skin manifestation was reported in three subjects. One subject was already diagnosed as CD. although prevalence of ESCC in northeast Iran is significantly higher than central Iran, the prevalence of gluten sensitive enteropathy is the same (1%). It dose not appear that CD has any impact on the prevalence of ESCC in Iran.