Celiac disease and pregnancy in Indian scenario

Authors

  • Anupam Verma Department of Obstetrics and Gynecology, L. L. R. M. Medical College, Meerut, Uttar Pradesh, India
  • Preeti Tyagi Department of Obstetrics and Gynecology, L. L. R. M. Medical College, Meerut, Uttar Pradesh, India
  • Anu Singh Department of Obstetrics and Gynecology, L. L. R. M. Medical College, Meerut, Uttar Pradesh, India http://orcid.org/0000-0003-2752-6160

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20181959

Keywords:

Celiac disease, Gluten enteropathy

Abstract

Celiac disease is a chronic lifelong inflammatory condition of gastrointestinal tract specifically the small intestine. We report a case of pregnancy outcome in a patient with celiac disease (gluten sensitive enteropathy) diagnosed during the investigations of recurrent abortions and intermittent diarrhoea since childhood.  A 32 years old patient who had four abortions and loss of a premature baby was diagnosed as celiac disease during investigations of recurrent abortions and diarrhoea since childhood. After stabilisation of disease she conceived spontaneously. Patient had regular follow up in some private institute. She was referred to our hospital as a case of IUGR with color Doppler changes with breech presentation with sluggish fetal movements at 37 weeks and emergency caesarean section was performed. A male fetus with 2.25 kg AS 7, 9 at birth was delivered. The cause of her recurrent pregnancy losses and previous preterm birth was celiac disease. Celiac disease (CD) is an immune-mediated enteropathy caused by a permanent sensitivity to gluten in genetically susceptible individual. It may also lead to serious maternal and fetal complications because of systemic effects of disease however a successful pregnancy outcome is possible when pre-gestational diagnosis is made and proper management of disease during pregnancy is achieved.

References

Danowski L, Brand LG, Connolly J. Selections from Current Literature: gluten-free diets, coeliac disease and associated disorders. Fam Pract. 2003;20:607-11.

Hin H, Bird G, Fisher P, Mahy N, Jewell D. Coeliac disease in primary care: case finding study. BMJ 1998;318:164-7.

Kaukinen K, Collin P, Holm K, Karvonen AL, Pikkarainen P, Maki M. Small bowel mucosal inflama-tion in reticulin or gliadin antibody positive patients without villous atrophy. Scand J Gastroenterol. 1998;33:944-9.

Fasano A, Catassi C. Current approaches to diagnosis and treatment of celiac disease: an evolving spectrum. Gastroenterol. 2001;120:636-51.

Fasano A, Berti I, Gerarduzzi T. Prevalence celiac disease in at risk and not-at-risk groups in the United States: a large multicenter study. Arch Intern Med. 2003;163:286-92.

Gomez JC, Selvaggio GS, Viola M. Prevalence of celiac disease in Argentina: screening of an adult population in the La Plata area. Am J Gastroenterol. 2001;96:2700-4.

Rewers M. Epidemiology of celiac disease: what are the prevalence, incidence, and progression of celiac disease? Gastroenterol. 2005;128(4)(1):S47-51.

Acerini CL, Ahmed ML, Ross KM, Sullivan PB, Bird G, Dungar DB. Coeliac disease in children and adolescents with IDDM: clinical characteristics and response to gluten-free diet. Diabet Med. 1998;15:38-44.

Carlsson A, Axelsson I, Borulf S. Prevalence of IgA- antiendomysium and IgA-antigliadin autoantibodies at diagnosis of insulin dependent diabetes mellitus in Swedish children and adolescents. Pediatr. 1999;103:1248-52

Cronin CC, Feighery A, Ferriss JB, Liddy C, Shanahan F, Feighery C. High prevalence of celiac disease among patients with insulin-dependent (type 1) diabetes mellitus. Am J Gastroenterol. 1997;92:2210-2.

Fraser-Reynolds K, Butzner J, Stephure D, Trussell R, Scott RB. Use of immunoglobulin: a antiendomysial antibody to screen for celiac disease in North American children with type 1 diabetes. Diabetes Care. 1998;21:1985-9.

Gillett PM, Gillett HR, Israel DM. High prevalence of celiac disease in patient with type 1 diabetes detected by antibodies to endomysium and tissue transglutaminase. Can J Gastroenterol. 2001;15:297-301.

Koletzko S, Burgin-Wolff A, Koletzko B. Prevalence of coeliac disease in diabetic children and adolescents: a multicenter study. Eur J Pediatr 1988;148:113-7.

Maki M, Huupponen T, Holm K, Hallstrom O. Seroconversion of reticulin autoantibodies predicts coeliac disease in insulin de-pendent diabetes mellitus. Gut. 1995;36:239-42.

Saukkonen T, Savilahti E, Reijonen H, Ilonen I, Tuomilehto-Wolf G, Akerblom HK. Coeliac disease: frequent occurrence after clinical onset of insulin dependent childhood diabetes in Finland Study Group. Diabet Med. 1996;13:464-70.

Savilahti E, Simell O, Kroskimies S, Rilva A, Akerblom HK. Celiac disease in insulin-dependent diabetes mellitus. J Pediatr. 1986;108:690-3.

Schober E, Bittman b, Granditsch G, et al. Screening by antiendomysium antibody for celiac disease in diabetic children and adolescents in Austria. J Pediatr Gastroenterol Nutr. 2000;30:391-6.

Sigurs N, Johansson C, Elfstrand P, Viander M, Lanner A. Prevalence of celiac disease in diabetic children in adolescents in Sweden. Acta Paediatr. 1993;82:748-51.

Hoffenberg EJ, Bao F, Eisenbarth GS. Transglutaminase antibodies in children with a genetic risk for celiac disease. J Pediatr. 2000;137(3):356-60.

Troncone R, Greco L, Auricchio S. Gluten sensitive entheropathy. Pediatr Clin North Am. 1996;43:355-73.

Sher KS, Mayberry JF. Female fertility, obstetrics and gynaecological history in coeliac disease: a case control study. Digestion. 1994;55:243-6.

Martinelli P, Tronce R, Paparo F. Coeliac disease and unfavourable outcome of pregnancy. Gut. 2000;46:332-5.

Ciacci C, Cirillo M, Auriemma G. Celiac disease and pregnancy outcome. Am J Gastroenterol. 1996;91:718-22.

King LA, Ciclitira PJ. Celiac disease. Current Opinion Gastroenterol. 2000;16:102-6.

Martinelli P, Tronce R, Paparo F. Coeliac disease and unfavourable outcome of pregnancy. Gut. 2000;46:332-5.

Anjum N, Baker PN, Robinson NJ, Aplin JD. Maternal celiac disease autoantibodies bind directly to syncytiotrophoblast and inhibit placental tissue transglutaminase activity. Reprod Biol Endocrinol. 2009;7:16.

Ciacci C, Cirillo M, Auriemma G. Celiac disease and pregnancy outcome. Am J Gastroenterol. 1996;91:718-22.

Rostami K, Steegers EAP, Wong WY, Braat DD, Steegers-Theunissen RPM. Coeliac disease and reproductive dis-orders: a neglected association. Eur J Obstet Gynecol Reprod Biol. 2001;96:146-9.

Ludvigsson JF, Montgomery SM, Ekbom A. Coeliac disease in the father and risk of adverse pregnancy outcome: a population-based cohort study. Scand J Gastroenterol. 2006;41:178-85.

Bougle D, Proust A. Iron and zinc supplementation during pregnancy: interactions and requirements. Contracept Fertil Steril. 1999;27:537-43.

Seibel MM. The role of nutrition and nutritional supplements in women’s health. Fertil Steril. 1999;72:579-91.

Nelen WLDM, Blom HJ, Steegers EAP. Homocystein and folate levels as risk factors for recurrent early pregnancy loss. Obstet Gynecol. 2000;95:519-24.

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Published

2018-04-28

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Case Reports