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Subject:
From:
Don Wiss <[log in to unmask]>
Date:
Thu, 16 Nov 1995 01:08:34 -0500
Content-Type:
text/plain
Parts/Attachments:
text/plain (57 lines)
<<Disclaimer: Verify this information before applying it to your situation.>>
 
On Thu, 16 Nov 1995 14:46:57 -0500, The SPRUENIK AFD had:
 
>Q:  How common is celiac disease?
>
>    Dr. Alexander:  In reviewing the syllabus for the Baltimore
>    conference, there are some points that I wonder about.  The
>    syllabus suggests the frequency of celiac disease (CD) may be one
>    in 250 people.  Perhaps it is in Ireland and certain other
>    locations where there is a homogenous population this may be true.
>    But could it really be one in 250 people in Italy, which is
>    practically synonymous with pasta?  You would expect there to be
>    an epidemic of complications.  Perhaps the definition of CD used
>    in these studies is less stringent than it is here.  If the
>    studies are based on symptoms or positive blood tests, they could
>    be including a lot of false positives in their statistics.  Or
>    perhaps the studies are based on relatives of celiacs, in which
>    case you would pick up a higher percentage of celiacs than you
>    would from the general population.
 
Here is the abstract for the Italian study:
 
Catassi C; Ratsch IM; Fabiani E; Rossini M; Bordicchia F; Candela F; Coppa
GV; Giorgi PL
Coeliac disease in the year 2000: exploring the iceberg [see comments]
Department of Pediatrics, University of Ancona, Italy.
Source:  Lancet 1994 Jan 22;343(8891):200-3
Comment in: Lancet 1994 Jan 22;343(8891):188
Comment in: Lancet 1994 Mar 12;343(8898):675
Comment in: Lancet 1994 Apr 16;343(8903):984
Unique Identifier:  94118649
 
Abstract:
 
  It is now generally believed that subclinical coeliac disease is
  common in the general population. We have undertaken screening
  for this disorder in a school district in central Italy.
  Screening was divided into three levels: first, IgG and IgA
  antigliadin antibody (AGA) assay on capillary blood obtained by
  finger prick; second, AGA plus IgA anti-endomysium antibody (AEA)
  test and measurement of serum immunoglobulins in venous blood;
  and third, intestinal biopsy. 3351 students (66% of the eligible
  population) aged 11-15 years attended first-level screening. 71
  (2%) were recalled because of AGA positivity; 18 of these
  satisfied second-level criteria and underwent intestinal biopsy.
  Coeliac disease was diagnosed in 11 subjects, most of whom had no
  serious symptoms. Selective IgA deficiency was found in 4
  subjects, 1 of whom also had coeliac disease. The prevalence of
  subclinical coeliac disease in the study group was 3.28 per 1000.
  Coeliac disease screening is feasible and involves only slight
  discomfort to the general population. Such screening can detect
  large numbers of cases of coeliac disease, which can be treated
  with a gluten-free diet. Many subclinical cases of coeliac
  disease would not be detected by screening only a selected group
  of at-risk patients.

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