Celiac disease revealed in 3% of Swedish 12-year-olds born during an epidemic
2009 (English)In: Journal of Pediatric Gastroenterology and Nutrition, ISSN 0277-2116, Vol. 49, no 2, 170-176 p.Article in journal (Refereed) Published
Objective:: Sweden experienced a marked epidemic of celiac disease between 1984 and 1996 in children younger than 2 years of age, partly explained by changes in infant feeding. The objective of this study was to determine the prevalence of celiac disease in 12-year-olds born during the epidemic (1993), including both symptomatic and screening detected cases. Patients and Methods:: All sixth-grade children in participating schools were invited (n = 10,041). Symptomatic and, therefore, previously diagnosed celiac disease cases were ascertained through the National Swedish Childhood Celiac Disease Register and/or medical records. All serum samples were analyzed for antihuman tissue transglutaminase (tTG)-IgA (Celikey), and serum-IgA, and some for tTG-IgG and endomysial antibodies. A small intestinal biopsy was recommended for all children with suspected undiagnosed celiac disease. Results:: Participation was accepted by 7567 families (75%). Previously diagnosed celiac disease was found in 67 children; 8.9/1000 (95% confidence interval [CI] 6.7-11). In another 192 children, a small intestinal biopsy was recommended and was performed in 180. Celiac disease was verified in 145 children, 20/1000 (95% CI 17-23). The total prevalence was 29/1000 (95% CI 25-33). Conclusions:: The celiac disease prevalence of 29/1000 (3%)-with two thirds of cases undiagnosed before screening-is 3-fold higher than the usually suggested prevalence of 1%. When these 12-year-olds were infants, the prevailing feeding practice was to introduce gluten abruptly, often without ongoing breast-feeding, which might have contributed to this unexpectedly high prevalence.
Place, publisher, year, edition, pages
2009. Vol. 49, no 2, 170-176 p.
Celiac disease; Children; Infant nutrition; Prevalence; Screening
National CategoryMedical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-21259DOI: 10.1097/MPG.0b013e31818c52ccOAI: oai:DiVA.org:liu-21259DiVA: diva2:241037