P4933 - The Effect of Concomitant Inflammatory Bowel Disease on Patients With Celiac Disease

Alexandria Markley, MD¹, Luis Rendon, MD², Swati Patel, MD¹, Yontan Israel, MD³, Carlos Diola, MD⁴, Peter Green, MD⁵, Haley Waite, MS⁶, Christopher Cao, MD^4
1Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, NY; ²Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, NY; ³Ichan School of Medicine at Mount Sinai, New York, NY; ⁴Icahn School of Medicine at Mount Sinai, New York, NY; ⁵New York-Presbyterian/Columbia University Irving Medical Center, New York, NY; ⁶Mount Sinai Health System, New York, NY

Introduction: A small proportion of patients with celiac disease (CeD) have concomitant inflammatory bowel disease (IBD), and the significance of a dual diagnosis (CeD-IBD) on the clinical presentation and disease course of CeD remains unclear. This study aims to compare CeD with CeD-IBD patients to better understand the impact of a concomitant IBD diagnosis for patients with CeD.

Methods: A retrospective chart review of patients with CeD and CeD-IBD from The Mount Sinai Hospital was performed. Charts were reviewed to ensure a 1:1 ratio of patients in each cohort. Inclusion criteria included individuals with CeD confirmed by serology and biopsy and CeD patients with a concomitant diagnosis of IBD confirmed by histology. Patients were excluded if data from the initial diagnosis was missing.

Results: A total of 38 CeD-IBD patients (60.5% female) were compared to 38 CeD patients (53% female). Celiac disease diagnosis occurred at an earlier age in the CeD-IBD cohort (23.0 years) compared to the CeD cohort (25.1 years). Diarrhea and abdominal pain were the most common presenting symptoms in both groups; CeD-IBD cohort presented with more hematochezia while CeD cohort presented with more bloating. The CeD cohort was more likely to be asymptomatic at time of diagnosis. On presentation, CeD-IBD had more severe disease (mean TTG IgA 108 U/mL; 68.4% Marsh 3) compared to the CeD cohort (mean TTG IGA 89 U/mL; 60.1% Marsh 3). CeD-IBD cohort had longer time to histologic remission (5.0 years) compared to the CeD cohort (3.3 years). Celiac remission was confirmed in 13 patients in the CeD-IBD cohort but only 3 patients in the CeD cohort. Enteropathy associated T-cell lymphoma was not seen in either cohort.

Discussion: The presentation of celiac disease in CeD-IBD patients trends towards being more clinically severe compared to patients with sole CeD. CeD-IBD patients also trend towards having a longer time to histologic remission. The higher rates of remission and earlier age at diagnosis of celiac disease documented in the CeD-IBD group may be a reflection of more frequent endoscopic surveillance in patients with a secondary IBD diagnosis.


Disclosures:


Alexandria Markley, MD¹, Luis Rendon, MD², Swati Patel, MD¹, Yontan Israel, MD³, Carlos Diola, MD⁴, Peter Green, MD⁵, Haley Waite, MS⁶, Christopher Cao, MD⁴. P4933 - The Effect of Concomitant Inflammatory Bowel Disease on Patients With Celiac Disease, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.