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Serological screening for celiac disease in healthy 2.5-year-old children in Sweden
A K Carlsson1, I E Axelsson, S K Borulf
1Department of Pediatrics, University of Lund, University Hospital, Malmö, Sweden. anneli.k.carlsson@skane.se
Insights
Celiac disease (CD) affects at least 1.0% of Swedish children, with potential prevalence reaching 2.0%. This study highlights CD as a common chronic disorder in pediatric populations.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Public Health
Background:
- Celiac disease (CD) is an autoimmune disorder triggered by gluten ingestion.
- Early diagnosis and management are crucial for preventing long-term complications.
- Sweden has a high incidence of celiac disease, necessitating population-based prevalence studies.
Purpose of the Study:
- To determine the prevalence of celiac disease in 2.5-year-old children in a Swedish urban population.
- To assess the frequency of both symptomatic and silent celiac disease.
Main Methods:
- Screening of 690 apparently healthy children using immunoglobulin A (IgA) antigliadin and IgA antiendomysium antibodies.
- Intestinal biopsy for antibody-positive cases.
- Inclusion of a child with confirmed CD via gluten-free diet response.
Main Results:
- A prevalence of 1.3% (9/690) for celiac disease was identified in the study cohort.
- Eight out of 12 children undergoing biopsy showed partial or total villous atrophy.
- An additional 22 symptomatic CD cases were identified in a larger birth cohort.
Conclusions:
- Celiac disease prevalence in this Swedish cohort is high, estimated between 1.0% and 2.0%.
- The findings underscore celiac disease as a common chronic disorder in children.
- Further investigation into silent CD prevalence is warranted.
Objective:
The study was designed to investigate the prevalence of celiac disease (CD) among 2.5-year-old children in a Swedish urban population with a high incidence of CD.
Material And Methods:
Six hundred ninety apparently healthy children, born in the 12-month period of July 1992 through June 1993, were screened for immunoglobulin A (IgA) antigliadin antibodies and IgA antiendomysium antibodies, and those antibody-positive at repeated testing were further investigated with intestinal biopsy.
Results:
Of the 690 children, 6 were both IgA antigliadin antibody- and IgA antiendomysium antibody-positive, and 7 were antiendomysium antibody-positive but antigliadin antibody-negative. Jejunal biopsy, performed in 12 cases, manifested partial or total villous atrophy in 8 cases. Thus, together with an additional child whose parents declined the offered biopsy, but whose response to a gluten-free diet confirmed the presence of CD, the prevalence of CD in the study series was 1.3% (9/690; 95% confidence interval:.4-2.2). However, independent of the study, an additional 22 cases of symptomatic, biopsy-verified CD have already been detected in the birth cohort of 3004 children.
Conclusions:
The prevalence of CD in our study series was high, at least 1.0%, but may be as high as 2.0% if the frequency of silent CD is as high as we have found in the remaining unscreened cohort. These findings confirm that CD is one of the most common chronic disorders.