title: High prevalence of celiac disease in Brazilian blood donor volunteers based on screening by IgA antitissue transglutaminase antibody.
abstract: OBJECTIVE
  To study the prevalence of celiac disease among blood donor volunteers based on screening by IgA antitissue transglutaminase antibody, followed by a confirmatory small intestine biopsy.
  
  
  METHODS
  The transversal study involved 3000 potential blood donors, residing in the city of Sao Paulo, Brazil. The participants were gender divided into 1500 men and 1500 women, with an average age 34.4+/-10.8 years, and included blood donor volunteers who could be turned down owing to anemia. All participants answered a questionnaire concerning the presence of diarrhea, constipation or abdominal pain during the 3 months before the study. Each participant with human recombinant IgA antitissue transglutaminase antibody level above 10 U/ml was invited to undergo a small intestine biopsy by means of an upper gastrointestinal endoscopy. The presence of villous atrophy and a positive antibody test were suggestive of possible celiac disease.
  
  
  RESULTS
  Antitissue transglutaminase antibody was positive in 1.5% (45/3000) of the study population. Among the antibody-positive group, 21 (46.6%) agreed to have a biopsy performed, and within them the histological pattern of villous atrophy was confirmed in 66.7% (14/21). Consequently, the suggestive prevalence of celiac disease was at the minimum, one per 214 of the potential blood donor volunteers. A significant association was found between celiac disease and the symptoms of diarrhea, constipation and abdominal pain.
  
  
  CONCLUSIONS
  The prevalence of celiac disease in Sao Paulo city is high and comparable to that observed in European countries. It is possible that in Brazil the prevalence of this disease had previously been underestimated.
authors.affiliation: Division of Pediatric Gastroenterology, Federal University of Sao Paulo, Paulista School of Medicine, Sao Paulo, Brazil.
authors.forename: Ricardo P
authors.initials: RP
authors.lastname: Oliveira
authors.forename: Vera L
authors.initials: VL
authors.lastname: Sdepanian
authors.forename: José A
authors.initials: JA
authors.lastname: Barreto
authors.forename: Afonso J P
authors.initials: AJ
authors.lastname: Cortez
authors.forename: Fabrício O
authors.initials: FO
authors.lastname: Carvalho
authors.forename: José O
authors.initials: JO
authors.lastname: Bordin
authors.forename: Maria Angélica
authors.initials: MA
authors.lastname: de Camargo Soares
authors.forename: Francy Reis
authors.initials: FR
authors.lastname: da Silva Patrício
authors.forename: Elisabete
authors.initials: E
authors.lastname: Kawakami
authors.forename: Mauro Batista
authors.initials: MB
authors.lastname: de Morais
authors.forename: Ulysses
authors.initials: U
authors.lastname: Fagundes-Neto
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D001782:Blood Donors / Q000706:statistics & numerical data*; D001824:Body Constitution; D001938:Brazil / Q000453:epidemiology; D002446:Celiac Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D019204:GTP-Binding Proteins / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D007413:Intestinal Mucosa / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D015995:Prevalence; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D007070:Immunoglobulin A; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins