Impact of modification of diagnostic techniques and criteria on the presentation of celiac disease in the last 16 years. Observation in Rome.
Age of diagnosis and clinical pattern were studied in 97 celiac patients, diagnosed with jejunal biopsy, between 1976-1991. They were selected on the basis of clinical and laboratory patterns. The laboratory tests utilized were steatorrhea and xylose in the first years, while in recent years AGA, ARA and AEA were also utilized. The patients were divided into two groups, based on the year of first biopsy. The first group includes 36 cases diagnosed between 1976-1985, the second one 61 cases diagnosed between 1986-1991. In recent years an increase in the number of cases has been observed in our centre, particularly in patients over 2 years of age, while the number of diagnoses in children under 2 years of age was essentially the same. So-called typical symptoms prevailed in the first group, while so-called atypical symptoms are more frequent in the second. If an increase of incidence of celiac disease within the population is confirmed, a mass screening will be necessary in order to identify the atypical forms, utilizing laboratory tests, for the purpose of selecting patients to be subjected to an intestinal biopsy.
Barbato
M
M
Clinica Pediatrica, Università degli Studi di Roma, La Sapienza.
Miglietta
M R
MR
Viola
F
F
Iulianella
V R
VR
Frediani
T
T
Lucarelli
S
S
Tozzi
A E
AE
Cardi
E
E
D000293:Adolescent; D000367:Age Factors; D001706:Biopsy; D002446:Celiac Disease / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D006130:Growth Disorders; D006801:Humans; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007223:Infant; D012189:Retrospective Studies; D014994:Xylose / Q000097:blood
D007070:Immunoglobulin A; D007074:Immunoglobulin G; D014994:Xylose