• Saed K H Owda, Hamza Yazji, Mohammed Al-Essi, Alaa Rustom, Fekri Mohammed, and Khamis Al-Essi.
• Faculty of Medicine, Islamic University, Gaza City, Gaza Strip, occupied Palestinian territory. Electronic address: saedowda@hotmail.com.
• Lancet. 2022 Jun 1; 399 Suppl 1: S7.

BackgroundCoeliac disease is an autoimmune disease of the small intestine precipitated by the ingestion of gluten in genetically susceptible individuals. Clinical presentation of patients with coeliac disease patients varies depending on age and has been associated with other autoimmune conditions. In the Gaza strip, the patterns of clinical presentations and associations have not been reported. We aimed to assess these factors.MethodsThis cross-sectional descriptive study was done in July, 2015. We administered a structured questionnaire to all patients who were diagnosed as having coeliac disease and were registered at Ard El Insan Association, a Palestinian charitable society that provides preventive and therapeutic services, family guidance, and health education to patients with nutritional diseases through clinics in the Gaza Strip. The questionnaire focused on the presenting symptoms, coexisting diseases, and the diet of each patient. Patients provided verbal consent for their data to be used in this study. We used SPSS Statistics version 23.0 for data management and descriptive statistical analysis.Findings55 patients aged 2-40 years were included in our study with a mean age of 20 (SD 11·7) years. 23 (42%) patients were younger than 18 years. 19 (34%) were boys or men and 36 (66%) were girls or women. The mean age of the first presentation with gastrointestinal complaints was 10 (SD 9) years, whereas the mean age of diagnosis was 16 (10) years. The most common presenting symptoms were anorexia (76%), abdominal distention (73%), and diarrhoea (73%). In addition, 78% of patients had poor weight gain, 71% had iron deficiency anaemia, 40% had arthralgia, and 33% had short stature and had experienced delayed puberty. 18 (33%) patients had a family history of coeliac disease. The proportion of patients who had other autoimmune diseases was 23%, with the most frequent being urticaria (9%), type 1 diabetes (4%), asthma (4%), alopecia (4%), and thyroiditis (2%). 44 (80%) patients adhered to therapeutic diets. The mean level of haemoglobin at diagnosis was 10·0 (SD 1·7) g/L, but at the latest visit was 11·6 (1·2) g/L.InterpretationOur findings suggest that coeliac disease occurs notably more frequently in girls and women than in boys and men in Gaza Strip and that diagnosis can take 5-6 years after the first gastrointestinal complaint. On the other hand, a substantial number of patients presented with non-gastrointestinal symptoms. Therefore, an awareness of the broad spectrum of presentations of coeliac disease is necessary to avoid delays in diagnosis.FundingNone.Copyright © 2022 Elsevier Ltd. All rights reserved.

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