<<Disclaimer: Verify this information before applying it to your situation.>> A study finds CD serological screening tests may not be as sensitive as thought, thus missing many cases of CD where only partial villous atrophy is present. And another study supports the notion that CD begins in childhood. A previous study in the UK found the prevalence of CD in children at age 7 similar to that of adults in the UK. Now a study of children under 3 years in Spain also shows a CD prevalence similar to that of adults, and this at a younger age than the UK study. In previous posts to the Celiac List, I have cited articles suggesting that the mix of gut flora significantly affects development of the immune system in infants. If there is a connection between gut bacteria and CD, then CD research needs to look at the intestinal flora of infants. ---------- Dig Dis Sci. 2004 Apr;49(4):546-50 Seronegative celiac disease: increased prevalence with lesser degrees of villous atrophy. Abrams JA, Diamond B, Rotterdam H, Green PH. Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA. Our aim was to assess differences in the sensitivities of serologic tests used for the diagnosis of celiac disease among patients with varying degrees of villous atrophy. Among 115 adults with biopsy-proven celiac disease who fulfilled strict criteria, including serologic testing at the time of diagnosis and response to a gluten-free diet, 71% had total villous atrophy and 29% partial villous atrophy. Endomysial antibody was positive in 77% of those with total villous atrophy, compared to 33% with partial villous atrophy (P < 0.001). There was no difference in sensitivity when the type of presentation (classical vs. silent) was compared. Endomysial antibody-positive and negative patients did not differ with respect to age at diagnosis, duration of symptoms, mode of presentation, or family history of celiac disease. All anti-tissue transglutaminase-positive patients had TVA on biopsy. Seronegative celiac disease occurs. Endomysial antibody positivity correlates with more severe villous atrophy and not mode of presentation of celiac disease. Serologic tests, in clinical practice, lack the sensitivity reported in the literature. PMID: 15185855 [PubMed - in process] ---------- J Pediatr Gastroenterol Nutr. 2004 Jul;39(1):80-84 Prospective Population Screening for Celiac Disease: High Prevalence in the First 3 Years of Life. Castano L, Blarduni E, Ortiz L, Nunez J, Bilbao JR, Rica I, Martul P, Vitoria JC. Endocrinology and Diabetes Research and Pediatric Units, Hospital de Cruces, Barakaldo, Hospital de Zumarraga and Hospital de Mendaro, Basque Country, Spain; Departments of Pediatrics, Nursing and Medicine, University of the Basque Country, Bilbao, Basque Country, Spain. BACKGROUND:: Celiac disease (CD) is an autoimmune enteropathy that develops in genetically susceptible individuals exposed to gliadin. Early diagnosis of CD may reduce the risk of complications, and several studies have related the duration of gluten exposure to the risk of other autoimmune diseases. It has been proposed that silent CD be diagnosed as soon as possible to avoid potential complications. OBJECTIVES:: The purpose of this study was to determine the prevalence of CD among children less than 3 years and to provide treatment to those patients diagnosed with CD. PATIENTS AND METHODS:: Parents of 1100 healthy children born between October 1998 and December 1999 were asked at the time of delivery to enroll their children in a program for the early diagnosis of CD. The parents of 830 children agreed to participate. Patients in the study were examined and anti-tissue transglutaminase antibody was first measured at about 1.5 years of age. A second antibody titer was obtained at about 2.5 years of age. Patients with detectable autoantibodies underwent intestinal biopsy for confirmation of CD. RESULTS:: Of the 830 children initially enrolled, 613 and 484 returned for the first and second visits, respectively. None had anti-tissue transglutaminase antibodies at the first visit, but 9 had anti- tissue transglutaminase immunoglobulins at the second visit. In 7 of these 9, intestinal biopsy confirmed the diagnosis of CD which suggests a minimum prevalence of CD of 1 per 118 healthy newborns. CONCLUSIONS:: The authors observed a very high prevalence of CD, comparable to that observed in other European populations, which might even be higher if all of the children initially examined had returned for their second visit. If general screening for CD were accepted, the authors would recommend age 2-3 years as the best time for measuring tissue transglutaminase antibodies. PMID: 15187786 [PubMed - as supplied by publisher] * * * * Please include your location in all posts about products *