The main purpose of our study is to investigate the prevalence of CD based on both serology and biopsy in dyspeptic patients and find out factors that predict high probability of CD in these patients

This study is a cross-sectional study on 530 randomly chosen adult dyspeptic patients who underwent endoscopy in a main referral university gastroenter¬ology clinic from 2016 to 2017. Data included demographic characteristics, chief complaints, family history (FH), pathology, endoscopy and laboratory results (complete blood count (CBC), iron profile (serum iron, Ferritin and total iron binding capacity(TIBC)), vitamin D3 (vit D) and IgA class human anti tissue transglutaminase (tTG) antibody). Intestinal biopsy and serum anti-tissue transglutaminase (anti-tTG) were used for diagnosis. Mucosal lesions were classified according to modified Marsh classification.

Overall 163(30.8 %) male and 367(69.2 %) female with a Mean age of 46.38±15.54 were included. 15(2.8%) had CD based on both endoscopy and serology confirmed CD, high ATTG level seen in 36(6.8%) patients and in duodenal pathology, clue of marsh 1-3 seen in 23 (4.5%) patients. 20%, 20% and 60% of patients are marsh1, 2 and 3 respectively. Logistic Regression analysis showed that IDA, ATTG level and helicobacter pylori infection are predictive factors for histological findings of marsh1-3 but IDA is the only predictive factor for CD in dyspeptic patients.

CD is prevalent in dyspeptic patients, but routine biopsy from normal appearing duodenal mucosa was not recommended. A pre-endoscopy celiac antibody test, serum ferritin level in conjunction with clinical history and family history and careful endoscopic evaluation may provide a cost-effective clinical algorithm that will improve the diagnostic yield of celiac disease in dyspeptic patients undergo an upper endoscopy.