Euroasian journal of hepato-gastroenterology · 2026
Demographic Profile and Clinical Presentation of Celiac Disease in the Pakistani Population: A Systematic Review and Meta-analysis.
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Khan Raja Ty, Luck Nasir H, Kumar Sanjay K, Ahsam Salman, Hyder Ali, Abrar Ghazi, Ismail Hina, Tasneem Abbas A
Аннотация
BACKGROUND: Celiac disease (CD) is an increasingly recognized autoimmune enteropathy triggered by gluten ingestion. While its global prevalence is well-documented, data from South Asia, particularly Pakistan, remain fragmented. This systematic review and meta-analysis aimed to consolidate available evidence on the demographic characteristics and clinical presentations of CD in the Pakistani population.
MATERIALS AND METHODS: A comprehensive literature search of PubMed, Google Scholar, and Cochrane databases was conducted in accordance with PRISMA guidelines. Studies were selected based on predefined PICOS criteria, including biopsy and serology-confirmed CD cases from Pakistan. Data extraction focused on demographics, symptoms, histology, laboratory parameters, and autoimmune associations. Statistical analysis was performed using a random-effects model.
RESULTS: Fourteen studies encompassing 1,578 patients were included. The pooled female prevalence was 51.5%, with mean ages of 7.6 years in pediatric and 35.5 years in adult patients. Iron deficiency anemia (65.9%) and diarrhea (64.6%) were the most common clinical presentations. Atypical presentations like bloating, oral ulcers, and psychiatric symptoms were also reported. Histologically, villous atrophy (96.9%) and intraepithelial lymphocytosis (84.5%) were predominant. Celiac disease was associated with autoimmune diseases, notably psoriasis (25%), hypothyroidism (12.6%), and autoimmune hepatitis (12.5%). Family history was reported in 10.6% of cases. Laboratory findings revealed low mean hemoglobin (9.57 gm/dL) and albumin (2.88 gm/dL), indicating nutritional compromise.
CONCLUSION: Celiac disease in Pakistan presents with a diverse clinical spectrum and frequent extraintestinal manifestations. Delayed diagnosis, nutritional deficiencies, and autoimmune overlap are common. Enhanced awareness and diagnostic accessibility are urgently needed to improve early recognition and management.
MATERIALS AND METHODS: A comprehensive literature search of PubMed, Google Scholar, and Cochrane databases was conducted in accordance with PRISMA guidelines. Studies were selected based on predefined PICOS criteria, including biopsy and serology-confirmed CD cases from Pakistan. Data extraction focused on demographics, symptoms, histology, laboratory parameters, and autoimmune associations. Statistical analysis was performed using a random-effects model.
RESULTS: Fourteen studies encompassing 1,578 patients were included. The pooled female prevalence was 51.5%, with mean ages of 7.6 years in pediatric and 35.5 years in adult patients. Iron deficiency anemia (65.9%) and diarrhea (64.6%) were the most common clinical presentations. Atypical presentations like bloating, oral ulcers, and psychiatric symptoms were also reported. Histologically, villous atrophy (96.9%) and intraepithelial lymphocytosis (84.5%) were predominant. Celiac disease was associated with autoimmune diseases, notably psoriasis (25%), hypothyroidism (12.6%), and autoimmune hepatitis (12.5%). Family history was reported in 10.6% of cases. Laboratory findings revealed low mean hemoglobin (9.57 gm/dL) and albumin (2.88 gm/dL), indicating nutritional compromise.
CONCLUSION: Celiac disease in Pakistan presents with a diverse clinical spectrum and frequent extraintestinal manifestations. Delayed diagnosis, nutritional deficiencies, and autoimmune overlap are common. Enhanced awareness and diagnostic accessibility are urgently needed to improve early recognition and management.