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Celiac Disease Revealed in 3% of Swedish 12-year-olds Born During an Epidemic.

Author

  • Anna Myléus
  • Anneli Ivarsson
  • Charlotta Webb
  • Lars Danielsson
  • Olle Hernell
  • Lotta Högberg
  • Eva Karlsson
  • Carina Lagerqvist
  • Fredrik Norström
  • Anna Rosén
  • Olof Sandström
  • Lars Stenhammar
  • Hans Stenlund
  • Stig Wall
  • Annelie Carlsson

Summary, in English

OBJECTIVE:: Sweden experienced a marked epidemic of celiac disease between 1984 and 1996 in children younger than 2 years of age, partly explained by changes in infant feeding. The objective of this study was to determine the prevalence of celiac disease in 12-year-olds born during the epidemic (1993), including both symptomatic and screening detected cases. PATIENTS AND METHODS:: All sixth-grade children in participating schools were invited (n = 10,041). Symptomatic and, therefore, previously diagnosed celiac disease cases were ascertained through the National Swedish Childhood Celiac Disease Register and/or medical records. All serum samples were analyzed for antihuman tissue transglutaminase (tTG)-IgA (Celikey), and serum-IgA, and some for tTG-IgG and endomysial antibodies. A small intestinal biopsy was recommended for all children with suspected undiagnosed celiac disease. RESULTS:: Participation was accepted by 7567 families (75%). Previously diagnosed celiac disease was found in 67 children; 8.9/1000 (95% confidence interval [CI] 6.7-11). In another 192 children, a small intestinal biopsy was recommended and was performed in 180. Celiac disease was verified in 145 children, 20/1000 (95% CI 17-23). The total prevalence was 29/1000 (95% CI 25-33). CONCLUSIONS:: The celiac disease prevalence of 29/1000 (3%)-with two thirds of cases undiagnosed before screening-is 3-fold higher than the usually suggested prevalence of 1%. When these 12-year-olds were infants, the prevailing feeding practice was to introduce gluten abruptly, often without ongoing breast-feeding, which might have contributed to this unexpectedly high prevalence.

Department/s

Publishing year

2009

Language

English

Pages

170-176

Publication/Series

Journal of Pediatric Gastroenterology and Nutrition - Jpgn

Volume

49

Document type

Journal article

Publisher

Lippincott Williams & Wilkins

Topic

  • Pediatrics

Status

Published

ISBN/ISSN/Other

  • ISSN: 1536-4801