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[Incidence of symptomatic celiac disease in French children]
J J Baudon1, A Dabadie, J Cardona
1Hôpital d'Enfants Armand-Trousseau, 26, avenue du Dr Arnold-Netter, F 75571 Paris. jean-jacques.baudon@trs.ap-hop-paris.fr
Insights
The annual incidence of symptomatic celiac disease in children is increasing, with most cases diagnosed before age two. Common symptoms include failure to thrive and diarrhea, indicating a rising public health concern for pediatric celiac disease.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Epidemiology
Context:
- Celiac disease is an autoimmune disorder triggered by gluten consumption.
- Previous studies indicated varying incidence rates in France.
- The Group for the Study of Pediatric Gastroenterology and Nutrition (GFHGNP) initiated this research.
Purpose:
- To determine the annual incidence of symptomatic celiac disease in children across France.
- To update epidemiological data on pediatric celiac disease.
- To compare current incidence with historical data.
Summary:
- The study collected data from 124 children diagnosed with celiac disease under 15 years old in 1996.
- The overall annual incidence was calculated as 0.41 per 1000 births (1/2419).
- Incidence varied geographically, with lower rates in major urban areas like Paris and Lyon.
Impact:
- The findings suggest a rising trend in symptomatic pediatric celiac disease incidence compared to earlier periods (1975-1990).
- Early diagnosis, often before age two, is crucial, with failure to thrive and diarrhea being primary symptoms.
- This research highlights the need for continued surveillance and awareness of celiac disease in pediatric populations.
Objective:
The study was carried out by the GFHGNP to determine the annual incidence of symptomatic celiac disease in children.
Patients And Methods:
The diagnostic criteria were: symptomatic patients diagnosed under 15 years of age during 1996, villous atrophy and positivity of antigliadin and/or other antibodies. Cases were collected from referral centers, general hospital pediatric departments and private pediatricians with endoscopic practice.
Results:
The study involved roughly half of the French pediatric population in 41 out of the 95 French districts. In all, 124 patients were collected: 76 girls and 48 boys. By geographical areas, in 30 districts where collection of data was complete which counted 186,285 births, the yearly incidence varied from 1/1731 births to 1/3110. (0.57@1000 to 0.32@1000). On the whole there were 77 cases i.e. an annual incidence of 1/2419 or 0.41@1000 (confidence interval 95%: 0.32 to 0.50@1000). Lower incidences were observed in the district of Paris: 1/4865 (0.21@1000) and Lyon: 1/3310 (0.27@1000). Those lower incidences could be explained by the difficulties of collecting the data in the biggest urban areas. The first signs occurred before one year of age in 73% of the cases, during the second year of life in 20.5% and after 3 in only 6.5%. The diagnosis was made before 2 years of age in 77% of the cases and after 3 in only 13%. In order of frequency symptoms were: failure to thrive (80%), diarrhea (59%), anorexia (59%), abdominal distension (57%), weight under 2 standard deviations (43%), short stature (43%).
Conclusion:
Compared with previous studies in two French districts between 1975 and 1990, the annual incidence of symptomatic celiac disease in children appears to be on the rise. The usual clinical signs continue to be observed.
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