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Subject:
From:
Albert D, Biderman <[log in to unmask]>
Date:
Thu, 29 Mar 2001 01:09:38 -0500
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<<Disclaimer: Verify this information before applying it to your situation.>>

I received several sorts of replies to my inquiry about this
undocumented assertion in a Medscape article last week:

     > Celiac disease occurs primarily in whites of
     > Northern European ancestry.

I was referred to the NIDDK website by one respondent.  This National
Institute's general article on CD has a different take on the
prevalence of CD in Europe than the Medscape piece I questioned.
NIDDK states:

>Celiac disease is the most common genetic disease in Europe. In Italy
>about 1 in 250 people and in Ireland about 1 in 300 people have celiac
>disease. . . .

Maybe the Medscape article's author confused the NIDDK statement about
CD being primary among genetic diseases in Europe with the proposition
that CD exists primarily among Europeans.

One reply I got suggested that the statement referred to "encyclopedic"
type of knowledge requiring no specific citation, but this list mate
also mentioned the exceptionally high rates reported in Italian studies,
and, as a few other replies observed, identifying Italy or Italians with
North Europe is a bit of a stretch.   Most of the replies disputed the
assertion about North Europe by mentioning findings of high rates of CD
in other places (or than among migrants of Northern European ancestry).
In addition to many references to Italy, other Southern European places
with middling-to-high reported rates included Spain, Greece and Croatia.
three people mentioned that the highest rate reported they have heard of
was the among Saharawi children in Algeria.  Ron Hoggan sent me a
citation for this "astounding" 5.6% rate, along with bibliography cites
for observations of the non-rarity of CD among south Asians and
elsewhere.  My own bibliographic search also turned up papers on CD in
South America, North Africa, the Middle East, and India.   In the other
direction, there is one Dutch study saying CD is rare in Holland in
comparison with some other countries and one Danish study finding Danish
rates low as compared with Sweden.  There was concern from listmates
whose CD was long overlooked that there would be failures to diagnose
cases where CD is mistakenly regarded as rare because no one would look for it.

One thing is certain about North Europe.  That area, and, secondarily,
Italy,  is where most of the literature on CD originates.  I rarely
spotted Japanese, Chinese or Korean author names in the biblio search
I did.   Also unlike the case with most bio-sci topics, relevant
articles by North Americans were infrequent.

The oft-mentioned predilection of Irish for CD apparently affects
Irish setter dogs, as well.  Although the article that I saw on this
found a different mechanism at work in the case of the dogs than with
the people, the differentiation would not have been feasible back when
I was first diagnosed (Polvi A, et al., Genetic susceptibility to
gluten sensitive enteropathy in Irish setter dogs is not linked to the
major histocompatibility complex. Tissue Antigens 1998 Dec;52(6):543-9
).

Since my original message, a related post appeared referring to the
History of CD section of Scott Adams' Celiac.Com site.  The theory
there requires opening a worm can I won't touch here.

I am not including cites to other points in this summary because of
its length and the extensiveness of the relevant bibliography.

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