Abstract
Background and Aims: In the last decade the diagnosis of celiac disease is frequently made in adults. Therefore it is important to determine disease prevalence (including silent and latent disease) in this population group. We performed serological screening of celiac disease in a representative and homogenous sample of young-adult general population in Israel.
Methods: The prevalence of overt celiac disease was determined in the 17-year old population of military recruits during 2003 through the medical database of the Israeli Defense Forces. Serum samples were obtained from a representative sample of 850 healthy recruits (men/female=1.1). Anti tissue trans-glutaminase (tTG)-IgA was determined by ELISA. In cases of borderline anti anti-tTG levels, IgA anti-endomysial-antibody (EMA) was determined by immunofluorescence microscopy. In cases of IgA deficiency, EMA-IgG was determined. A small intestinal biopsy was offered to all patients who tested positive for at least one serologic marker. Results: The prevalence of overt celiac disease diagnosed prior to recruitment was 0.12% (0.1% in men and 0.14% in women). The overall prevalence based on positive serology (at least one marker) was 1.1% (9/850, male/female= 1.25). 6 of 9 subjects with positive serology agreed to undergo endoscopy and intestinal biopsies. In all cases, biopsies were compatible with celiac disease (5 biopsies were graded as March 3a and one as March 3b). One subject previously suffering from IBS-like symptoms was diagnosed as suffering
from overt atypical celiac disease. The prevalence of overt celiac diagnosed by screening was 0.12% (1/850). The other patients were asymptomatic. The prevalence of silent disease was 0.6-0.9%. No cases of latent disease were encountered. No cases of celiac disease were diagnosed in IgA deficient persons (4/850). Conclusions: The ratio of overt to silent celiac disease was 1/8-1/5 .Serological screening doubled the number of diagnoses of overt disease.
No latent disease was found, and therefore a gluten free diet was indicated in all cases that were diagnosed by screening.
Methods: The prevalence of overt celiac disease was determined in the 17-year old population of military recruits during 2003 through the medical database of the Israeli Defense Forces. Serum samples were obtained from a representative sample of 850 healthy recruits (men/female=1.1). Anti tissue trans-glutaminase (tTG)-IgA was determined by ELISA. In cases of borderline anti anti-tTG levels, IgA anti-endomysial-antibody (EMA) was determined by immunofluorescence microscopy. In cases of IgA deficiency, EMA-IgG was determined. A small intestinal biopsy was offered to all patients who tested positive for at least one serologic marker. Results: The prevalence of overt celiac disease diagnosed prior to recruitment was 0.12% (0.1% in men and 0.14% in women). The overall prevalence based on positive serology (at least one marker) was 1.1% (9/850, male/female= 1.25). 6 of 9 subjects with positive serology agreed to undergo endoscopy and intestinal biopsies. In all cases, biopsies were compatible with celiac disease (5 biopsies were graded as March 3a and one as March 3b). One subject previously suffering from IBS-like symptoms was diagnosed as suffering
from overt atypical celiac disease. The prevalence of overt celiac diagnosed by screening was 0.12% (1/850). The other patients were asymptomatic. The prevalence of silent disease was 0.6-0.9%. No cases of latent disease were encountered. No cases of celiac disease were diagnosed in IgA deficient persons (4/850). Conclusions: The ratio of overt to silent celiac disease was 1/8-1/5 .Serological screening doubled the number of diagnoses of overt disease.
No latent disease was found, and therefore a gluten free diet was indicated in all cases that were diagnosed by screening.
| Original language | English GB |
|---|---|
| Pages (from-to) | A364-A364 |
| Journal | Gastroenterology |
| Volume | 134 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 2008 |