Prevalence of silent coeliac disease in atopics.
BACKGROUND
Coeliac disease sometimes runs a subclinical/silent course and is often associated with immunologic and non-immunologic diseases. Although atopy is described as one of the most frequently associated conditions, the prevalence of coeliac disease in atopics has not yet been established.


OBJECTIVE
To evaluate the frequency of coeliac disease in an Italian series of atopics.


METHODS
Sera from 401 consecutive atopics with no clinical evidence of malabsorption were tested for IgA antiendomysial antibodies by indirect immunofluorescence on human umbilical cord and IgA anti tissue transglutaminase by enzyme-linked immunosorbent assay Results. Four patients (1%) were found to be positive for both autoantibodies. Intestinal biopsy confirmed the diagnosis of active coeliac disease. One of the 4 coeliacs was also affected by Down's syndrome, autoimmune thyroiditis and coeliac hepatitis. In another case, a previously unknown severe iron deficiency was detected.


CONCLUSIONS
The present study shows, for the first time, that the prevalence of coeliac disease in atopics is 1%, which is significantly higher than that in the general Italian population. Therefore, atopy should be considered a condition at risk and atopic patients routinely screened by means of specific autoantibody testing.
Zauli
D
D
Department of Internal Medicine, Cardioangiology, Hepatology, University of Bologna, Italy. dzauli@almadns.unibo.it
Grassi
A
A
Granito
A
A
Foderaro
S
S
De Franceschi
L
L
Ballardini
G
G
Bianchi
F B
FB
Volta
U
U
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000888:Antibodies, Anti-Idiotypic / Q000032:analysis*; D002446:Celiac Disease / Q000453:epidemiology* / Q000276:immunology; D002648:Child; D015897:Comorbidity; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology* / Q000276:immunology; D007070:Immunoglobulin A / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D010328:Patch Tests; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution
D000888:Antibodies, Anti-Idiotypic; D007070:Immunoglobulin A