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Changes in coeliac disease behaviour over the years
Insights
The incidence of coeliac disease in Sicilian children has increased, with diagnoses rising after the antigliadin antibody test was introduced. Chronic diarrhea remains the most common symptom, appearing early in life.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Epidemiology
Background:
- Coeliac disease is an autoimmune disorder triggered by gluten.
- Early diagnosis and management are crucial for preventing long-term complications in children.
- The introduction of serological markers like antigliadin antibodies has improved diagnostic capabilities.
Purpose of the Study:
- To investigate trends in coeliac disease incidence and clinical presentation in Sicilian children.
- To evaluate the impact of introducing the antigliadin antibody test on diagnosis rates.
- To describe the typical age of onset and key symptoms in pediatric coeliac disease.
Main Methods:
- Retrospective study of 325 coeliac children diagnosed between 1984 and 1989 in Sicily.
- Children divided into two groups based on diagnosis period: 1984-1986 (pre-antibody test) and 1987-1989 (post-antibody test).
- Analysis of demographic data, age at onset, age at diagnosis, and clinical symptoms.
Main Results:
- A significant increase in diagnoses was observed after the introduction of the antigliadin antibody test (117 cases pre-test vs. 208 cases post-test).
- Disease onset and diagnosis predominantly occurred within the second year of life, with peaks around 9 and 12 months, respectively.
- Chronic diarrhea was the most frequent symptom (70-75%), while other symptoms like short stature and delayed puberty showed no significant changes.
Conclusions:
- Coeliac disease incidence has been increasing in Sicily, particularly following the adoption of serological testing.
- The classic clinical presentation, characterized by chronic diarrhea and growth failure in early childhood, remains prevalent.
- The antigliadin antibody test has enhanced the early detection of coeliac disease in pediatric populations.
Abstract:
We performed a retrospective study of 325 coeliac children (179 females and 146 males, F/M ratio 1:2), diagnosed from 1984 to 1989. The children were divided into two groups; group A were diagnosed between 1984 and 1986 and group B were diagnosed between 1987 and 1989, when the antigliadin antibody test had been introduced in our routine. The data showed a difference between the number of diagnoses in the two groups, 117 in group A versus 208 in group B, with a yearly increment of new cases. In both groups, the onset of the disease occurred within the 2nd year of life, in most cases (group A, 88.9%; group B 89.4%) showing a mode at approximately the 9th month. Diagnosis was made within the 2nd year of life in the majority of cases (group A, 80.3%; group B, 87.4%), showing a mode of approximately the 12th month. In both groups, chronic diarrhoea was the most frequent symptom (75.2% in group A and 70.2% in group B), while minor symptoms, such as isolated short stature, pallor, delayed puberty and others, did not show any important change. We conclude that in Sicily, in recent years, the incidence of coeliac disease has been increasing. The most representative clinical form is the classic one, with onset within the 2nd year of life, and chronic diarrhoea, growth failure and abdominal distention as key symptoms.