title: [Twenty years of childhood coeliac disease in the Netherlands: more diagnoses and a changed clinical picture].
abstract: OBJECTIVE
  To assess the incidence of childhood coeliac disease in the Netherlands and to study the clinical features.
  
  
  METHODS
  Prospective.
  
  
  METHODS
  Leiden University Medical Centre, Leiden, the Netherlands.
  
  
  METHODS
  Cases of childhood coeliac disease in the Netherlands in 1993-1995 were identified by means of the Dutch Paediatric Surveillance Unit. Inclusion criteria were: birth in the Netherlands, diagnosis with at least one small bowel biopsy in 1993-1995 and age at diagnosis 0-14 years. The data were cross checked with the Dutch Network and National Database of Pathology and compared with data from a previous study on childhood coeliac disease, 1975-1990.
  
  
  RESULTS
  297 Coeliac patients were identified by means of the Surveillance Unit, another 32 through the National Database of Pathology. The mean crude incidence rate of diagnosed childhood coeliac disease was 0.51/1000 live births, which was in the range of rates found in other West European countries and significantly higher than the mean crude incidence rate of 0.18/1000 live births found in the Netherlands in 1975-1990. The clinical presentation was classic up to 1990: chronic diarrhoea, abdominal distention and growth failure. From 1993 onward, however, the number of children with chronic diarrhoea and abdominal distention decreased significantly and the number with weight loss, anaemia and abdominal pain increased. Associated disorders were present in 13.7% of the cases.
  
  
  CONCLUSIONS
  The incidence of diagnosed childhood coeliac disease in the Netherlands showed a tendency to increase significantly during the past decade. In a period of 20 years a significant trend toward change in the clinical presentation of coeliac disease in Dutch children was observed.
authors.affiliation: Leiden Universitair Medisch Centrum.
authors.forename: E K
authors.initials: EK
authors.lastname: George
authors.forename: M L
authors.initials: ML
authors.lastname: Mearin
authors.forename: S M
authors.initials: SM
authors.lastname: Kanhai
authors.forename: H C
authors.initials: HC
authors.lastname: Franken
authors.forename: R H
authors.initials: RH
authors.lastname: Houwen
authors.forename: R A
authors.initials: RA
authors.lastname: Hirasing
authors.forename: J P
authors.initials: JP
authors.lastname: Vandenbroucke
mesh_terms: D000293:Adolescent; D002446:Celiac Disease / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011446:Prospective Studies; D017678:Sex Distribution
vernacular_title: Twintig jaar coeliakie bij kinderen in Nederland: meer diagnosen en een veranderde verschijningsvorm.