Clinical portraits of patients with gluten-associated diseases (according to the North-West Center for the Treatment of Patients with Gluten-Associated Diseases)

Aim. To present the interim results of the work of the specialized Register of gluten-associated disorders, created at the North-West Center for the Treatment of Gluten-Associated Disorders (NWCT GAD) on the basis of the Department of Internal Medicine Propedeutics, Gastroenterology and Dietetics n.a. S.M. Ryss, the Mechnikov North-Western State Medical University.

Materials and methods. From November 2022 to January 2024, 120 patients were examined on the basis of the NWCT GAD, of which 60 patients met the requirements of the Register and were regarded as patients with gluten intolerance or a genetic predisposition to it.

Results. The average age of patients was 35.4 ± 12 years, women predominated – 56.7%. In the structure of nosological forms of GAD, the diagnosis of “celiac disease” was more common (55%). In 23 patients, the primary diagnosis of celiac disease was revised due to the lack of criteria for the disease due to erroneous interpretation of the results and insufficient examination. Gastrointestinal symptoms were observed in 74.2%, extraintestinal manifestations – in 85.5% of patients. Among the patients included in the Register, 31 (51.7%) person had already followed a gluten-free diet for more than 3 months, but in 29 persons various clinical manifestations were observed. There was comorbidity of gluten intolerance with functional diseases of the pancreatobiliary system (41.7%) and chronic gastritis (33.3%).

Conclusion. Thus, further work of the Register allows us to obtain new data on the course and prognosis of GAD, improve the diagnostic algorithm for certain forms of gluten intolerance with the formation of an observation plan and a version of the elimination protocol, which will affect the improvement of the quality of medical care and the quality of patients’ life.