PREVALENCE OF CELIAC DISEASES (CD) IN AT RISK GROUPS OF CHILDREN IN THE USA

Abstract

Use of serological tests in Europe demonstrates CD is more common than realized. In contrast, CD is regarded as rare in the USA. It is possible the condition is underdiagnosed in this country. Aim. To determine the prevalence of CD in conditions associated with CD. Methods. Children with abdominal pain, chronic diarrhea, failure to thrive, short stature, type 1 diabetes, a miscellaneous group and asymptomatic relatives of proven cases were tested for antibodies to gliadin (AGA IgG & IgA) and endomysium (EMA). Those with positive EMA and select patients with positive AGA were offered intestinal biopsy for confirmation. Results. Patient groups and test results are shown in the table. Biopsies in EMA positive patients confirmed CD in 8/9. Four patients refused biopsy and in 11, biopsies have yet to be obtained. At least 1:96 (8/771) patients screened have CD. This figure may be as low as 1:40 (19/771) when additional patients undergo biopsy. Conclusions. CD appears much more frequent than previously reported in the USA. Serological tests should be used more frequently to identify patients who need intestinal biopsy. There is need for large scale epidemiological studies in the USA to establish the precise prevalence of CD in this country.