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[Celiac disease in Piedmont. An epidemiological-clinical study]
N Ansaldi1, D Dell'Olio, K Tavassoli
1Instito Discipline Pediatriche, Università di Torino.
Insights
The incidence of coeliac disease (CD) in Turin was lower than the Italian average. Delayed diagnosis may contribute to a perceived decrease in new pediatric CD cases.
Area of Science:
- Pediatric Gastroenterology
- Epidemiology
- Immunology
Background:
- Coeliac disease (CD) is a significant autoimmune disorder.
- Understanding regional incidence and prevalence is crucial for public health planning.
- Previous studies have indicated geographical variations in CD rates.
Purpose of the Study:
- To calculate the incidence and prevalence of coeliac disease in children in Turin and the Piedmont Region.
- To analyze trends in age at onset and diagnosis over time.
- To investigate potential factors influencing observed incidence rates.
Main Methods:
- Retrospective epidemiological study.
- Inclusion criteria: 304 patients under 18 born in Turin (1975-1989) for incidence; 494 patients in Piedmont for prevalence.
- Data collection on demographics, age at onset, and diagnosis.
Main Results:
- Mean crude yearly incidence of CD in Turin: 0.511/1000 live births (1:1957).
- Mean crude incidence in Italy was 1.2/1000 live births (1:833), twice the Turin rate.
- Paediatric CD prevalence in Piedmont: 113 per million inhabitants.
- Age at diagnosis increased significantly from 15 months (1981) to 7 years (1989).
- Symptoms became less numerous and more atypical in older children.
Conclusions:
- Turin exhibited a lower CD incidence compared to the national average.
- Increasing age at diagnosis and atypical symptoms in older children may lead to underestimation of true incidence.
- The prevalence of CD is expected to rise due to normal life expectancy.
Abstract:
The incidence of coeliac disease (CD) was calculated on 304 patients under eighteen who were born in the city of Turin and its province in the years 1975-1989; the prevalence on 494 patients who live in the Piedmont Region. The mean crude yearly incidence was 0.511/1000 (1:1957 live birth). It varied from year to year, reaching minimum values in the years 1984-1987. In a contemporary epidemiological study, the mean crude incidence of CD in Italy was 1.2/1000 (1:833 live birth) twice the rate observed in Turin. The prevalence of paediatric CD in Piedmont was 113 per million inhabitants. Since CD has a normal life expectancy, its prevalence may be expected to increase. In the provinces of Novara, Alessandria and Asti CD prevalence was lower than in the others. Mean age at onset was 6 mos in 1975 and increased to 34 mos in 1989. Mean age at diagnosis was 15 mos in 1981, and 7 yrs in 1989. Symptoms were more numerous and severe in patients under 12 mos of age, and became fewer and often atypical in older children. We can therefore speculate that the trend towards a decreasing incidence of CD in recent years my be due to delayed diagnosis.