<<Disclaimer: Verify this information before applying it to your situation.>>
Thanks to everyone who kindly did searches in an attempt to help me
locate the 2.25:100 prevalence number I remember learning about on
this list.
The gold star goes to Ron Hoggan, who forwarded an extract
summarizing the study I had in mind. Now I see that my memory was
incorrect. The study measured prevalence in a population that had
symptoms associated with celiac, not in a general healthy population.
You can see the write-up, below.
The most solid, current figure for the general population is,
apparently, plus or minus 1:100. The information is spotty so far,
but there are indications that 1:100 may apply to many peoples around
the world and not just to populations of Northern European descent.
If you wish more detail, do a search using the name Catassi. He's the
researcher Dr. Green is quoting when he cites the 1:100 number.
Thanks again, everyone.
Mary B.
NYC
Am J Gastroenterol. 2007 Mar 13; [Epub ahead of print] Links
Detection of Celiac Disease in Primary Care: A Multicenter Case-Finding
Study in North America.Catassi C, Kryszak D, Louis-Jacques O, Duerksen DR,
Hill I, Crowe SE, Brown AR, Procaccini NJ, Wonderly BA, Hartley M D P,
Moreci J, Bennett N, Horvath K, Burk M, Fasano A.
Mucosal Biology Research Center and Division of Pediatric Gastroenterology
and Nutrition, University of Maryland School of Medicine, Baltimore,
Maryland, USA.
BACKGROUND: Celiac disease (CD) is one of the most common lifelong disorders
in western countries. However, most cases remain currently undiagnosed in
North America, mostly due to poor awareness of CD by primary care
physicians. OBJECTIVES: The aims of this study were (a) to determine whether
an active case-finding strategy in primary care could increase the frequency
of CD diagnosis and (b) to determine the most common clinical presentations
of the condition. METHODS:This was a multicenter, prospective study
involving adult subjects during the years 2002-2004, attending one of the
participating practices. All individuals with symptoms or conditions known
to be associated with CD were tested for immunoglobulin A
anti-transglutaminase (tTG) antibodies, and those with elevated anti-tTG
were subsequently tested for IgA antiendomysial antibodies (EMA). All
subjects who were positive for EMA were advised to undergo an intestinal
biopsy and HLA typing. RESULTS: The study group included 737 women and 239
men, with a median age of 54.3 yr. A positive anti-tTG test was found in 30
out of 976 investigated subjects (3.07%, 95% CI 1.98-4.16). CD was diagnosed
in 22 patients (18 women, 4 men). The most frequent reasons for CD screening
in these 22 cases were bloating (12/22), thyroid disease (11/22), irritable
bowel syndrome (7/22), unexplained chronic diarrhea (6/22), chronic fatigue
(5/22), and constipation (4/22). The prevalence of CD in the serologically
screened sample was 2.25% (95% CI 1.32-3.18). The diagnostic rate was low at
baseline (0.27 cases per thousand visits, 95% CI 0.13-0.41) and
significantly increased to 11.6 per thousand visits (95% CI 6.8-16.4, P <
0.001) following active screening implementation. CONCLUSIONS: This study
demonstrates that an active case-finding strategy in the primary care
setting is an effective means to improve the diagnostic rate of CD in North
America.
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