title: Spanish national registry of celiac disease: incidence and clinical presentation.
abstract: OBJECTIVE
  The aim of this study was to assess the incidence and clinical pattern of celiac disease (CD) presently diagnosed in Spanish children.
  
  
  METHODS
  A prospective, multicenter, nationwide registry of new cases of CD in children <15 years was conducted from June 1, 2006 to May 31, 2007. The parameters studied were age at diagnosis, sex, clinical symptoms, associated diseases, nutritional status, CD serology, histological lesions, and HLA-DQ2/-DQ8. The crude incidence rate of CD was calculated as new cases per 1000 live births and as new cases per 100,000 person-years <15 years of age.
  
  
  RESULTS
  A total of 974 new cases of CD were included. The median age at diagnosis was 2.3 years; 39.5% of CD diagnoses occurred in the first 2 years, 42% between 2 and 6, and 18.4% from 6 to 15. Total number of cases in each age group was 385, 409, and 180, respectively. Regarding clinical presentation 70.9% showed classical symptoms, 21.9% were nonclassical, and 7% were asymptomatic. A total of 95.7% of 931, 94.7% of 611, and 86.7% of 651 children tested positive, respectively, for immunoglobulin A (IgA) anti-transglutaminase type 2 antibodies, IgA endomysial antibodies, and IgA anti-gliadin antibodies. Villous atrophy was observed in 92.4% and increased intraepithelial lymphocytes with crypt hyperplasia in 3.3%. Of the children, 55% had normal growth, and 3.4% were overweight. The HLA phenotype was DQ2: 88.3%, DQ2/DQ8: 8.4%, and DQ8: 2.3%. The incidence rate was 7.9 cases of CD per 1000 live births and 54 cases per 100,000 person-years.
  
  
  CONCLUSIONS
  In Spain, the most frequent clinical presentation of CD is the classical form, mainly diagnosed during the first 2 years of life. The observed incidence of CD in Spanish children is much higher than the present CD incidence rates observed in other European countries.
authors.affiliation: *Hospital Severo Ochoa †Hospital Universitario Puerta de Hierro-Majadahonda, Madrid ‡Hospital Virgen del Camino, Pamplona §Hospital Universitario y Politécnico La Fe, Valencia ||Complejo Hospitalario Xeral-Cies, Vigo ¶Hospital Niños de Barcelona, Barcelona #Hospital San Pedro de Alcántara, Cáceres **Hospital Universitario Niño Jesús, Madrid ††Hospital Marqués de Valdecilla, Santander ‡‡Hospital Clínico Universitario de Santiago de Compostela, A Coruña §§Hospital de Torrecárdenas, Almería ||||Hospital Universitario Virgen de la Candelaria, Tenerife ¶¶Hospital de Fuenlabrada, Madrid ##Complejo Hospitalario Universitario de Albacete, Albacete ***Hospital Virgen del Rocío, Sevilla †††Hospital Universitario Sant Joan de Reus, Tarragona ‡‡‡Hospital Materno-Infantil, Las Palmas §§§Hospital Txagorritxu, Vitoria ||||||||||Hospital General de Móstoles, Madrid ¶¶¶Hospital Clínico Universitario de Valladolid, Valladolid ###Hospital Clínico Universitario de Salamanca, Salamanca ****Hospital Universitario de Canarias, Tenerife ††††Hospital Doce de Octubre, Madrid ‡‡‡‡Hospital Universitario de San Juan, Alicante §§§§Hospital Universitario Central de Asturias, Asturias, Spain.
authors.forename: M Luz
authors.initials: ML
authors.lastname: Cilleruelo
authors.forename: Enriqueta
authors.initials: E
authors.lastname: Roman-Riechmann
authors.forename: Felix
authors.initials: F
authors.lastname: Sanchez-Valverde
authors.forename: Ester
authors.initials: E
authors.lastname: Donat
authors.forename: Jose
authors.initials: J
authors.lastname: Manuel-Ramos
authors.forename: Emilio
authors.initials: E
authors.lastname: Martín-Orte
authors.forename: Maria-Jose
authors.initials: MJ
authors.lastname: López
authors.forename: Dolores
authors.initials: D
authors.lastname: García-Novo
authors.forename: Salvador
authors.initials: S
authors.lastname: García
authors.forename: Pilar
authors.initials: P
authors.lastname: Pavón
authors.forename: Manuel
authors.initials: M
authors.lastname: Martín
authors.forename: Luis
authors.initials: L
authors.lastname: Ortigosa
authors.forename: Josefa
authors.initials: J
authors.lastname: Barrio
authors.forename: Carolina
authors.initials: C
authors.lastname: Gutierrez
authors.forename: Beatriz
authors.initials: B
authors.lastname: Espìn
authors.forename: Gemma
authors.initials: G
authors.lastname: Castillejo
authors.forename: Luis
authors.initials: L
authors.lastname: Peña-Quintana
authors.forename: Idoia
authors.initials: I
authors.lastname: Hualde
authors.forename: Mercedes
authors.initials: M
authors.lastname: Sebastián
authors.forename: Carmen
authors.initials: C
authors.lastname: Calvo
authors.forename: Sonia
authors.initials: S
authors.lastname: Fernández
authors.forename: Julio
authors.initials: J
authors.lastname: De Manueles
authors.forename: Honorio
authors.initials: H
authors.lastname: Armas
authors.forename: Pedro
authors.initials: P
authors.lastname: Urruzuno-Tellerias
authors.forename: Mercedes
authors.initials: M
authors.lastname: Juste
authors.forename: Carlos
authors.initials: C
authors.lastname: Bousoño
authors.forename: Carmen
authors.initials: C
authors.lastname: Ribes-Koninckx
mesh_terms: D000906:Antibodies / Q000097:blood*; D001835:Body Weight; D002446:Celiac Disease / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006683:HLA-DQ Antigens / Q000097:blood; D006801:Humans; D015994:Incidence; D007413:Intestinal Mucosa / Q000276:immunology / Q000473:pathology; D008214:Lymphocytes / Q000378:metabolism*; D008297:Male; D010641:Phenotype; D012042:Registries; D013030:Spain / Q000453:epidemiology
chemical_list: D000906:Antibodies; D006683:HLA-DQ Antigens