Serological screening for celiac disease in healthy 2.5-year-old children in Sweden.
OBJECTIVE
The study was designed to investigate the prevalence of celiac disease (CD) among 2.5-year-old children in a Swedish urban population with a high incidence of CD.


METHODS
Six hundred ninety apparently healthy children, born in the 12-month period of July 1992 through June 1993, were screened for immunoglobulin A (IgA) antigliadin antibodies and IgA antiendomysium antibodies, and those antibody-positive at repeated testing were further investigated with intestinal biopsy.


RESULTS
Of the 690 children, 6 were both IgA antigliadin antibody- and IgA antiendomysium antibody-positive, and 7 were antiendomysium antibody-positive but antigliadin antibody-negative. Jejunal biopsy, performed in 12 cases, manifested partial or total villous atrophy in 8 cases. Thus, together with an additional child whose parents declined the offered biopsy, but whose response to a gluten-free diet confirmed the presence of CD, the prevalence of CD in the study series was 1.3% (9/690; 95% confidence interval:.4-2.2). However, independent of the study, an additional 22 cases of symptomatic, biopsy-verified CD have already been detected in the birth cohort of 3004 children.


CONCLUSIONS
The prevalence of CD in our study series was high, at least 1.0%, but may be as high as 2.0% if the frequency of silent CD is as high as we have found in the remaining unscreened cohort. These findings confirm that CD is one of the most common chronic disorders.
Carlsson
A K
AK
Department of Pediatrics, University of Lund, University Hospital, Malmö, Sweden. anneli.k.carlsson@skane.se
Axelsson
I E
IE
Borulf
S K
SK
Bredberg
A C
AC
Ivarsson
S A
SA
D001284:Atrophy; D001706:Biopsy; D002446:Celiac Disease / Q000175:diagnosis* / Q000178:diet therapy / Q000453:epidemiology*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D007583:Jejunum / Q000473:pathology; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D015995:Prevalence; D012016:Reference Values; D012698:Serologic Tests; D013548:Sweden / Q000453:epidemiology
D007070:Immunoglobulin A; D007074:Immunoglobulin G