title: The epidemiology of coeliac disease in South Wales: a 28-year perspective.
abstract: OBJECTIVE
  The diagnosis of coeliac disease (CD) has increased in frequency, particularly since the accuracy of serological antibody testing has improved. Previous studies from South Wales have shown an increase in the frequency of diagnosis from 1983 to 2004 with a decrease in specific gastro-intestinal symptoms, as well as an increasing age at diagnosis.
  
  
  OBJECTIVE
  We aimed to determine whether the frequency of diagnosis, the age at presentation and the clinical presentation of CD have changed between 2005 and 2011 compared with previously published data from 1983 to 2004. We reviewed all patients with CD presenting to the South Wales' Regional Centre between 2005 and 2011 and compared the age and documented mode of presentation with previous data from the same area.
  
  
  RESULTS
  163 cases of CD were diagnosed between 2005 and 2011 (23 cases/year) with the median age at diagnosis increasing to 14 years (range 0.8-16 years) compared with 50 cases (8/year) between 1999 and 2004 (median age at diagnosis 8 years), 25 cases (2.5/year) between 1990 and 1998 and 11 cases (1.5/year) between 1983 and 1989. 41% presented with specific gastro-intestinal symptoms, 23% with non-gastro-intestinal features and 36% were asymptomatic and diagnosed after serological screening of high-risk groups. Compared with the most recent previous study from the same population, the percentage of patients presenting with gastro-intestinal symptoms remain similar (42% vs 41%) but patients diagnosed after targeted screening had increased from 26% to 36%.
  
  
  CONCLUSIONS
  The frequency of diagnosis of CD in this defined population has continued to rise, with an increase in the median age at diagnosis, and over 50% of patients exhibited few or no symptoms.
authors.affiliation: Department of Paediatric Gastroenterology, Children’s Hospital for Wales, Cardiff, UK.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Whyte
authors.forename: Huw R
authors.initials: HR
authors.lastname: Jenkins
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002446:Celiac Disease / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008403:Mass Screening / Q000379:methods*; D013997:Time Factors; D014852:Wales / Q000453:epidemiology
keywords: Epidemiology; Gastroenterology; General Paediatrics; Paediatrics