Coeliac disease: incidence and prevalence in Wellington 1985-92

A retrospective study was carried out in the greater Wellington area. The objectives of this study were to identify an incidence rate, presenting symptoms and clinical features of coeliac disease.

Histology archives from the Wellington hospital department of pathology over the last eight years (1985-92) were retrieved and analysed. Abnormal duodenal and jejunal histological sections were reviewed. One hundred and seventy seven biopsy specimens from 127 patients were identified for further study from a total of 367 abnormal duodenal and jejunal biopsy specimens. Diagnosis of coeliac disease was based on information from hospital notes, biopsy request forms, and histology reports. Diagnostic criteria used for coeliac disease were evidence of malabsorption, abnormal histology consistent with coeliac disease and clinical improvement following a gluten free diet.

Thirty eight patients were diagnosed with coeliac disease 1985-92 in a population of 267,252. Of these 38 only four were children (0-12 years). Overall incidence was 1.8 per 100,000. The estimated overall prevalence was 70 per 100,000, with 14 per 100,000 for children. The live birth rate was 0.1 per 1000. There was a female predominance of 3:1. Patients presented with a diverse range of problems, most commonly diarrhoea, anaemia, weight loss and steatorrhoea. Three out of the 6 patients who had a single problem had anaemia.

The study has demonstrated an overall incidence and prevalence of coeliac disease in the Wellington region similar to overseas figures. However only 11% of the total were children, which is a very low proportion compared to the 50% reported in Sweden and 25% in Edinburgh. Patients presented with a wide range of clinical features. The threshold for small bowel biopsy should be relatively low in any patient considered to have clinical features of malabsorption.