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Rise and fall of coeliac disease 1960-85
D A Kelly1, A D Phillips, E J Elliott
1Queen Elizabeth Hospital for Children, London.
Insights
This study on childhood coeliac disease found that while incidence peaked in the 1970s, later presentation ages are now common. Breastfeeding and delayed gluten introduction may influence presentation age.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Epidemiology
Background:
- Childhood coeliac disease (coeliac disease) incidence and presentation patterns have evolved.
- Understanding factors influencing presentation age is crucial for early diagnosis and management.
Purpose of the Study:
- To investigate the frequency and age of presentation of childhood coeliac disease.
- To explore potential correlations between feeding practices, gluten introduction, and disease presentation age.
Main Methods:
- Retrospective review of 192 children diagnosed with coeliac disease between 1960-1985.
- Analysis of presentation age, feeding methods (breast vs. bottle), and age of gluten introduction.
Main Results:
- A peak incidence of childhood coeliac disease occurred between 1971-1975, with subsequent stabilization.
- Children presented at a later age over the study period, with breastfed infants presenting later than bottle-fed infants.
- Delayed gluten introduction (median 4 months post-1975 vs. 2 months pre-1975) correlated with later presentation ages.
Conclusions:
- Breastfeeding and the timing of gluten introduction appear to influence the age of presentation for childhood coeliac disease.
- The specific reasons for the 1970s incidence rise remain undetermined.
- While the disease is not declining, recent trends show a tendency for later presentation in children.
Abstract:
A total of 192 children who presented with coeliac disease to Queen Elizabeth Hospital for Children from 1960-85 were reviewed in order to investigate the frequency and the age of presentation. There was a clear peak in the number of children presenting from 1971-5, and although the numbers declined subsequently they have remained at a level similar to numbers found before 1971. There was no difference in the mode of presentation but there was a definite increase in the age of presentation over the time period reviewed. Breast fed babies presented later than bottle fed babies (14 compared with 9 months) despite a similar age of gluten introduction. Similarly bottle fed babies and breast fed babies presented later after 1975 (10.5 compared with 7 months, and 18 compared with 9.5 months, respectively). Before 1975 the median age of gluten introduction was significantly less than that after 1975 (2 compared with 4 months) and the age of gluten introduction correlated with the age of presentation. It is concluded that breast feeding and the age of gluten introduction may influence the age of presentation of childhood coeliac disease but no clear reasons for the rise in incidence in the 1970s have been determined. It does not appear that the disease is declining, however, in recent years children have tended to present later in life.