COELIAC DISEASE. HOW BIG IS THE ICEBERG
Dotti M, Montanelli A, Farina GP, Ravelli A, Catassi. University of Brescia, university of Ancona,, Italy
Acta Paediatr Suppl. 1996 May;412:29-35.The coeliac iceberg in Italy. A multicentre antigliadin antibodies screening for coeliac disease in school-age subjects.
Catassi C1, Fabiani E, Rätsch IM, Coppa GV, Giorgi PL, Pierdomenico R, Alessandrini S, Iwanejko G, Domenici R, Mei E, Miano A, Marani M, Bottaro G, Spina M, Dotti M, Montanelli A, Barbato M, Viola F, Lazzari R, Vallini M, Guariso G, Plebani M, Cataldo F, Traverso G, Ventura A, et al.
BACKGROUND: Recent studies suggest that coeliac disease (CD) is one of the commonest, life-long disorders in Italy. The aims of this multicentre work were: (a) to establish the prevalence of CD on a nationwide basis; and (b) to characterize the CD clinical spectrum in Italy.
PATIENTS AND METHODS: Fifteen centres screened 17,201 students aged 6-15 years (68.6% of the eligible population) by the combined determination of serum IgG- and IgA-antigliadin antibody (AGA) test; 1289 (7.5%) were IgG and/or IgA-AGA positive and were recalled for the second-level investigation; 111 of them met the criteria for the intestinal biopsy: IgA-AGA positivity and/or AEA positivity or IgG-AGA positivity plus serum IgA deficiency.
RESULTS: Intestinal biopsy was performed on 98 of the 111 subjects. CD was diagnosed in 82 subjects (75 biopsy proven, 7 not biopsied but with associated AGA and AEA positivity). Most of the screening-detected coeliac patients showed low-grade intensity illness often associated with decreased psychophysical well-being. There were two AEA negative cases with associated CD and IgA deficiency. The prevalence of undiagnosed CD was 4.77 x 1000 (95% CI 3.79-5.91), 1 in 210 subjects. The overall prevalence of CD, including known CD cases, was 5.44 x 1000 (95% CI 4.57-6.44), 1 in 184 subjects. The ratio of known to undiagnosed CD cases was 1 in 7.
CONCLUSIONS: These findings confirm that, in Italy, CD is one of the most common chronic disorders showing a wide and heterogeneous clinical spectrum. Most CD cases remain undiagnosed unless actively searched
HIGH PREVALENCE OF COELIAC DISEASE AMONG SWEDISH ADULTS
Hernell O, Ivarsson A, Persson LÅ, Juto P, Suhr O, Umeå University, Sweden
REGIONAL DANISH COELIAC DISEASE
Weile B, Krasilnikoff PA, Gentofte Hospital, Hvidövre Hospital, Copenhagen
INCIDENCE OF COELIAC DISEASE IN NORTHERN GERMANY
Peters U, Kayser H, Jung A, Erbersdobler HF. University of Kiel, Germany
FAMILIAL INCIDENCE OF COELIAC DISEASE IN POLAND
Grzenda-Adamek Z, Stopyrowa J, Pituch-Noworolska A, Miezynski W. University, Krakow, Poland
A POPULATION BASED STUDY OF COELIAC DISEASE IN A EUROPEAN COUNTRY. THE SAN MARINO
Blagi F, Andreani ML, Stefano M, Corrao G,Pretolani S, Giulianelli G, Brusco G, Arfilli L, Malservisi S, Ghironzi G,Taglieri G, GasbarriniG, Corazza GR.
COELIAC DISEASE RISK IN USA: HIGH PREVALENCE OF ANTIGLIADIN AND ANTIENDOMYSIUM ANTIBODIES IN HEALTHY BLOOD DONORS IN THE USA
Not T, Horvath K, Hill I, Partanen J, Magazzu G, Fasano A.
Prevalence 1:250 . Coeliac disease is underdiagnosed in USA.
HIGH PREVALENCE OF CELIAC DISEASE AMONG HEALTHY CHILDREN AND YOUNG ADULTS IN FINLAND
May be 1:75 in population under 30 years. Using antigliadinantibody (AGA) testing as a primary screening method, only a proportion of patients with silent celiac disease may be found.
Kolho K-L, Åkerblom H, Viikari J, Savilahti E.