Pulmonary Manifestations of Systemic Disease: Pulmonary Manifestation of Systemic Disease |

Pulmonary Function Test Characteristics in Celiac Disease FREE TO VIEW

Carl Ruthman, MD; Norlalak Jiramethee, MD; Gaja Shaughnessy, MD; Ali Alsaad, MBBCh; Jose Yataco, MD; Emir Festic, MD
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Mayo Clinic, Jacksonville, FL

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):1071A. doi:10.1016/j.chest.2016.08.1178
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SESSION TITLE: Pulmonary Manifestation of Systemic Disease

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: Celiac disease is an autoimmune condition where genetically predisposed individuals develop multisystem manifestations as a result of exposure to dietary proteins found in wheat, barley or rye. Pulmonary hemosiderosis is a well described complication of celiac disease in the pediatric population, where it is referred to as Lane-Hamilton Syndrome (LHS). Rare case reports of LHS occurring in adults are available; however to our knowledge no cohort studies investigating the pulmonary characteristics of the celiac population have been conducted. Here we report the pulmonary function test (PFT) characteristics of a cohort of patients with celiac disease from our institution.

METHODS: Using Advanced Cohort Explorer (ACE) Software, our team mined the electronic medical records of patients seen at Mayo Clinic in Rochester, MN for pathology and laboratory reports including the words celiac or dermatitis herpetiformis or reports indicating positive tissue transglutaminase or anti-endomysial antibodies. These charts were then manually reviewed to confirm the presence of celiac disease diagnosis and all PFTs that were performed in these patients were analyzed.

RESULTS: Manual review of data after search by ACE identified 750 individual patients with confirmed celiac disease from 1/1/2012 to June 30, 2014. Sixty-four of these patients had undergone at least one pulmonary function test, 40 (63%) of which were female. The median age was 43 (26, 63) and the median % predicted values of PFT components were as follows: FEV1 94 (82, 106), FVC 97 (89, 108), and DLCO 92 (81, 101). The median BMI was 26. Forty-three patients (67%) had normal PFT results. The most common abnormality was obstruction, identified in 17 (26%) patients with median FEV1% predicted being 50 (41, 64). Although the most frequent obstructive disease diagnosed was asthma, the median age in those with obstruction versus the rest of the cohort were 68 (54, 74) and 35 (18, 53), respectively.

CONCLUSIONS: The most common PFT abnormality in a longitudinal cohort of patients with celiac disease was obstruction, mainly attributable to asthma despite the relatively advanced age compared to those with normal PFTs.

CLINICAL IMPLICATIONS: Extraintestinal manifestations of celiac disease are becoming increasingly more clinically recognized.

DISCLOSURE: The following authors have nothing to disclose: Carl Ruthman, Norlalak Jiramethee, Gaja Shaughnessy, Ali Alsaad, Jose Yataco, Emir Festic

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