Preliminary results from follow‐up of a large‐scale population survey of antibodies to gliadin, reticulin and endomysium

Abstract

Coeliac disease is often under‐diagnosed, particularly in cases which are atypical or asymptomatic. Objective: The aim of this study was to comprehensively assess the prevalence and clinical profile of adult coeliac disease in our community. Methods: One‐hundred‐and‐thirteen subjects from the most recent MONICA (Multinational MONItoring of trends and determinants in CArdiovascular disease) 1991/2 survey with positive serology were followed up 3 years after initial screening and assessed by means of (i) a clinical questionnaire, (ii) screening blood tests, and (iii) jejunal biopsy. Results: Forty‐six subjects (21 male, mean age 51 years) have been followed up to date. Prior to follow‐up, two of these subjects were diagnosed as having coeliac disease. Ten (3 male, mean age 51 years) of 44 subjects had enteropathy. Three of these 10 subjects were relatively asymptomatic, 3 had folate deficiency and 3 had iron deficiency. Thus 12 of the 1823 initially screened had enteropathy consistent with coeliac disease. Conclusions: Coeliac disease is more prevalent than previous estimations and was found to be at least 1 in 152.

Diagnosis of Coeliac Disease at Open-Access Endoscopy

“…Coeliac disease is common in Western Europe, affecting 1:300 Italian schoolchildren (2), 1:250 Swedish blood donors (3), and 1:150 of a general population in Northern Ireland (4). On the basis of the last figure, approximately 10,000 of Northern Ireland's population of 1.6 million will develop coeliac disease, yet only 909 members of the Coeliac Society had Northern Ireland addresses in December 1996 (Coeliac Society, personal communication).…”

Prevalence of celiac disease in Brazilian children of short stature

“…Antiendomysial antibody has been shown to have a high sensitivity and specificity for the diagnosis of celiac disease and correlates well with villous atrophy in untreated patients, but false-negative results have been obtained for patients with IgA deficiency, justifying its measurement (29)(30)(31)(32). However, an intestinal biopsy continues to be the Gold Standard for the diagnosis of celiac disease (6,7).…”

Celiac sprue and related diseases

“…The development of sensitive and specific antibody tests made widespread screening feasible. In persons of Western European heritage, the prevalence of CS is about one in 250, as determined by antibody testing with biopsy confirmation [14][15][16][17]. In recent reports most cases of CS do not present with overt generalized malabsorption but rather with more subtle findings, such as iron deficiency anemia [18][19][20].…”

“…There are a variety of tests for bacterial overgrowth, including quantitative culture of a small-bowel aspirate, 14 C-xylose breath test, or lactulose-H 2 breath test, for example. There are also a variety of antibiotic regimens to chose from.…”