3/2007Celiac disease and women’s fertility

AGNIESZKA TOPCZEWSKA-CABANEK (Katedra i Zakład Medycyny Rodzinnej z Oddziałem Klinicznym Chorób Wewnętrznych i Metabolicznych Akademii Medycznej w Warszawie; Kierownik: prof. dr hab. med. Kazimierz A. Wardyn)

Summary
Celiac disease (CD – celiac sprue) is an autoimmune disorder. CD is defined as a permanent intolerance to gluten which induce characteristics enteropathy in genetically predisposed individuals. Epidemiological studies revealed celiac disease to be common, occurring in approximatelly 1% of the population. Classic celiac disease may start usually at an early age but it is also possible in pregnancy or in puerperium and presents as a malabsorption (chronic diarrhea, weight loss). The definitive diagnosis of celiac disease is made by fulfilling the triad of a positive serologic test antibodies against endomysium (EMA) and antibodies against tissue transglutaminase (tTG), histology (classification of Marsh) and favorable clinical and serological response following a gluten-free diet (GFD) without wheat, rye, barley and oat. Literature was surveyed. Adults women have a silent or atypical form of the disease, often extraintestinal manifestation delayed menstruation, irregular menstruation, amenorrhea, early menopause, recurrent miscarriages or infertility. It was observed that even one year treatment with gluten-free diet and correction of deficient dietary elements (vitamins, micro- and macroelements) can lead to a return of fertility in woman.

Key words: celiac disease, menarche, recurrent miscarriages, infertility