International Journal of Celiac Disease, 2017, Vol. 5, No. 1, 1-9 Available online at http://pubs.sciepub.com/ijcd/5/1/3 ©Science and Education Publishing DOI:10.12691/ijcd-5-1-3 Extra Intestinal Manifestations of Celiac Disease and Associated Disorders Abbasi Najmeh, Allameh Seyed Farshad * Tehran University of Medical Sciences, Iran *Corresponding author: allamehfarshad@gmail.com Abstract Celiac disease (CD) is one of the most common causes of chronic malabsorption in all over the world. CD damage the small intestine epithelial layer. Reduction of absorptive surface area and digestive enzymes, cause impairment of absorption of micronutrients such as fat-soluble vitamins, iron and vitamin B12 and folic acid. Sensitivity to gluten is the main pathophysiologic cause of CD and it is characterized by intraepithelial lymphocytosis, crypt hyperplasia and villous atrophy. CD has diverse clinical features includes anemia, fatigue, weight loss, diarrhea, abdominal pain, bloating, osteoporosis and depression. CD is commonly seen in association with extra intestinal manifestations, such as the typical skin lesions and the neurologic symptoms. Because of the broad spectrum of its presentations, the diagnosis may not be so obvious or easy.Having greater awareness and lower threshold for testing for CD are necessary for diagnosis of this disease. When CD is suspected, serologic testing is required for screening and subsequently duodenal biopsies are necessary to confirm the diagnosis. In this review article we want to review the extra intestinal manifestations of CD and also describe the association between CD and other disorders. It is useful for better diagnosis of CD and improvement of treatment of associated conditions. Future studies should focus on the extra intestinal presentations and associated disorders of gluten sensitivity as they could help better understanding the pathogenesis of gluten sensitivity. In this review article we describe these issues: 1. CD and psychiatric disorders; 2. CD and neurologic disorders; 3. CD and cardiac manifestation; 4. CD and liver disease; 5. CD and Endocrine disease; 6. CD and Dermatologic disease; 7. CD and Rheumatologic disorders; 8. CD and Ophthalmologic disease; 9. CD and Reproductive problems; 10. CD and associations with some other disease. Keywords: celiac disease, extra intestinal manifestations Cite This Article: Abbasi Najmeh, and Allameh Seyed Farshad, “Extra Intestinal Manifestations of Celiac Disease and Associated Disorders.” International Journal of Celiac Disease, vol. 5, no. 1 (2017): 1-9. doi: 10.12691/ijcd-5-1-3. 1. Introduction Celiac disease (CD) is one of the most common causes of chronic malabsorption in all over the world. [1] CD damage the small intestine epithelial layer. Reduction of absorptive surface area and digestive enzymes, cause impairment of absorption of micronutrients such as fat-soluble vitamins, iron and vitamin B12 and folic acid. [2,3] Sensitivity to gluten is the main pathophysiologic cause of CD and it is characterized by intraepithelial lymphocytosis, crypt hyperplasia and villous atrophy. [4,5] CD has diverse clinical features includes anemia, fatigue, weight loss, diarrhea, abdominal pain, bloating, osteoporosis and depression. [6,7] The prevalence of CD is estimated to be approximately 1% in western countries. [8,9,10] CD is commonly seen in association with extra intestinal manifestations, such as the typical skin lesions and the neurologic symptoms. [11,12] Because of the broad spectrum of its presentations, the diagnosis may not be so obvious or easy. [13] Having greater awareness and lower threshold for testing for CD are necessary for diagnosis of this disease. When CD is suspected, serologic testing is required for screening and subsequently duodenal biopsies are necessary to confirm the diagnosis. [14] Anti-tissue transglutaminase and anti endomysial Antibodies are highly sensitive and specific for diagnosis of CD, [15,16] but histologic studies are the gold standard for establishing the diagnosis. [17] In this article we want to review the extra intestinal manifestations of CD and also describe the association between CD and other disorders. It is useful for better diagnosis of CD and improvement of treatment of associated conditions. Future studies should focus on the extra intestinal presentations and associated disorders of gluten sensitivity as they could help better understanding the pathogenesis of gluten sensitivity. 2. CD and Psychiatric Disorders Association of CD and schizophrenia has been described for years. [18-25] Some studies demonstrate that CD patients are at increased risk of schizophrenia and there is association between them. [18,26] It has recently showed that the immune response to gluten in schizophrenic