TOPLINE:

Patients with celiac disease exhibited distinct symptom profiles across racial and ethnic groups. Although most diagnosed cases were reported in White patients, non-White individuals frequently presented with different — and often more severe — clinical manifestations.

METHODOLOGY:

• Despite clear diagnostic guidelines and known autoimmune associations, screening and case recognition of celiac disease remain low, creating an evidence gap in how disease presentation varies by race and ethnicity.
• Researchers conducted a retrospective cohort study, analyzing data of 171,447 patients with celiac disease (mean age, 43 years; 70.9% female) from a global database to characterize racial and ethnic differences in symptoms and comorbidities.

TAKEAWAY:

• Overall, 159,544 (93%) patients were White, 5627 (3%) were Black, 3919 (2%) were Hispanic, and 2357 (1%) were Asian.
• Black or African American vs White patients with celiac disease were more likely to have a history of constipation (30% vs 20%), adult failure to thrive (2% vs 1%), abnormal weight loss (13% vs 9%), epilepsy and recurrent seizures (5% vs 3%), and hypokalemia (13% vs 7%; P < .0001 for all).
• Both Black and Hispanic patients more commonly reported prior nausea and vomiting (33% vs 25%; P < .0001 for both) and skin paresthesias (12% and 11% vs 9%, respectively; P < .05 for both) than did their White counterparts.
• Asian and Hispanic patients were more likely than White patients to have gaseous abdominal distension (16% and 15% vs 12%; P < .0001 for both).

IN PRACTICE:

“This study highlights the urgent need to reconsider current diagnostic practices and guidelines, especially given that CeD [celiac disease] symptoms may manifest differently based on racial or ethnic background. Increased awareness and equitable application of screening protocols are essential,” the authors of the study wrote.

SOURCE:

The study was led by Joy Zhao, MD, Thomas Jefferson University, Philadelphia. It was published online in Gastro Hep Advances.

LIMITATIONS:

The study was limited by its reliance on retrospective data from electronic health records and self-reported race and ethnicity. Additionally, underreporting dermatitis herpetiformis and vitamin deficiencies may have limited the interpretability of the findings.

DISCLOSURES:

The study did not receive any specific funding. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.