A 10-year serological follow-up of celiac disease in an Estonian population.
BACKGROUND
Celiac disease (CD) is induced by wheat gluten and related prolamines. Its prevalence may be underestimated in many geographic regions and populations, and has recently increased in several countries. In 1998 and 1999, a random sample of Estonian schoolchildren was screened with IgA-type tissue transglutaminase antibodies (IgA-tTG) for CD. The results revealed a CD prevalence of 0.34%, which is lower compared with many other European countries.


OBJECTIVE
We rescreened the same population for CD using IgA-tTG after a 10-year interval.


METHODS
A total of 891 patients from the initial sample were rescreened using the IgA-tTG assay for a participation rate of 76.8% (median age, 24.3 years). As in the initial study, the IgA-tTG results were evaluated by ImmunoCAP EliA Celikey using an IgG-tTG and deamidated gliadin antibody assay for IgA-deficient cases.


RESULTS
No new cases of CD were found in this follow-up study. Of note, 75% of patients with initial IgA-tTG-positive results and biopsy-proven CD remained seropositive. One patient with a negative seroconversion at the time of rescreening followed a strict gluten-free diet during the follow-up years.


CONCLUSIONS
In a 10-year follow-up period, no new cases of CD were found in this Estonian population of school-children and young adults. Therefore, we presume no increase in CD during the last decade among this age group in Estonia. Additional studies are needed to determine whether similar results would be obtained in other age groups, because of differences in the CD prevalence between Estonian and other European populations.
Immunology Group, Institute of General and Molecular Pathology and Center of Excellence for Translational Medicine, University Hospital, University of Tartu, Tartu, Estonia.
Kadri
K
Lillemäe
Krista
K
Ress
Jaanus
J
Harro
Liis
L
Merenäkk
Heidi-Ingrid
HI
Maaroos
Raivo
R
Uibo
Oivi
O
Uibo
D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000097:blood; D002446:Celiac Disease / Q000175:diagnosis / Q000453:epidemiology*; D004812:Epidemiologic Methods; D004957:Estonia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D008297:Male; D011503:Transglutaminases / Q000276:immunology; D055815:Young Adult
D001323:Autoantibodies; D007070:Immunoglobulin A; D011503:Transglutaminases