title: Undetected coeliac disease in the elderly: a biopsy-proven population-based study.
abstract: BACKGROUND
  Up to 1% of the population suffer from coeliac disease. Data on the prevalence in elderly people is scant. We hypothesized that they would over time have developed obvious symptoms. Clinically silent or undiagnosed disease would thus be relatively uncommon.
  
  
  OBJECTIVE
  To evaluate the prevalence of coeliac disease in elderly people.
  
  
  METHODS
  The study comprised 2815 individuals aged 52-74 years. Clinical cases of coeliac disease were recorded. Sera from all subjects were screened by IgA class tissue transglutaminase antibodies, and seropositive underwent small bowel biopsy.
  
  
  RESULTS
  Coeliac disease was detected in altogether 60 individuals, in 25 (0.89%) on clinical grounds, and screening found in 35 (1.24%) new biopsy-proven cases. Thus, a total prevalence of 2.13% (95% confidence intervals 1.60-2.67%) was reached. Of the screen-detected cases, 15 had symptoms, albeit mostly mild. Two out of the 60 had small bowel T-cell lymphoma and two had gastric cancer. The total frequency of biopsy-proven coeliac disease and seropositive cases without histological confirmation was 2.45% (1.88-3.02%).
  
  
  CONCLUSIONS
  The prevalence of coeliac disease in elderly people was higher than what has been reported in the population in general. Active case finding by serologic screening is encouraged, since undetected cases may be prone to increased morbidity and mortality.
authors.affiliation: Department of Neurology, Päijät-Häme Central Hospital, Lahti, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Vilppula
authors.forename: P
authors.initials: P
authors.lastname: Collin
authors.forename: M
authors.initials: M
authors.lastname: Mäki
authors.forename: R
authors.initials: R
authors.lastname: Valve
authors.forename: M
authors.initials: M
authors.lastname: Luostarinen
authors.forename: I
authors.initials: I
authors.lastname: Krekelä
authors.forename: H
authors.initials: H
authors.lastname: Patrikainen
authors.forename: K
authors.initials: K
authors.lastname: Kaukinen
authors.forename: L
authors.initials: L
authors.lastname: Luostarinen
mesh_terms: D000368:Aged; D001706:Biopsy; D002446:Celiac Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011503:Transglutaminases / Q000276:immunology
chemical_list: D007070:Immunoglobulin A; D011503:Transglutaminases