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High prevalence of undiagnosed coeliac disease in adults: a Swedish population-based study.
J Intern Med 1999; 245(1):63-8JI

Abstract

OBJECTIVE

To determine the prevalence of coeliac disease in a population-based sample of Swedish adults.

DESIGN

Population-based cross-sectional study.

SETTING

Northern Sweden.

SUBJECTS

A total of 1894 adults (76%) out of 2500 invited, randomly selected from the population register after stratification for age and sex.

MAIN OUTCOME MEASURES

Prevalence of biopsy verified coeliac disease, symptoms of undiagnosed cases, and results of antiendomysium and antigliadin serum antibody tests.

RESULTS

Coeliac disease was confirmed by intestinal biopsy showing enteropathy in 10 individuals (seven women and three men), corresponding to a prevalence of 5.3 per 1000 (95% CI = 2.5-9.7). The majority of cases (eight out of 10) had not been diagnosed prior to the screening, although many had symptoms compatible with coeliac disease. All individuals with antiendomysium antibody positivity who were subjected to a small intestinal biopsy had enteropathy. Furthermore, all of them also had elevated levels of antigliadin antibodies type IgA and/or IgG.

CONCLUSIONS

Coeliac disease is common, albeit mostly undiagnosed, in Swedish adults. It is likely that the situation is no better in other countries. This highlights the importance of keeping coeliac disease in mind, and of promptly investigating individuals with unexplained, even mild, symptoms compatible with the disease. Serological markers, e.g. antigliadin and antiendomysium antibodies, are useful tools within this active case-finding strategy, although the final diagnosis should be based on an intestinal biopsy demonstrating enteropathy.

Authors+Show Affiliations

Department of Epidemiology & Public Health, Umeå University, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10095818

Citation

Ivarsson, A, et al. "High Prevalence of Undiagnosed Coeliac Disease in Adults: a Swedish Population-based Study." Journal of Internal Medicine, vol. 245, no. 1, 1999, pp. 63-8.
Ivarsson A, Persson LA, Juto P, et al. High prevalence of undiagnosed coeliac disease in adults: a Swedish population-based study. J Intern Med. 1999;245(1):63-8.
Ivarsson, A., Persson, L. A., Juto, P., Peltonen, M., Suhr, O., & Hernell, O. (1999). High prevalence of undiagnosed coeliac disease in adults: a Swedish population-based study. Journal of Internal Medicine, 245(1), pp. 63-8.
Ivarsson A, et al. High Prevalence of Undiagnosed Coeliac Disease in Adults: a Swedish Population-based Study. J Intern Med. 1999;245(1):63-8. PubMed PMID: 10095818.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High prevalence of undiagnosed coeliac disease in adults: a Swedish population-based study. AU - Ivarsson,A, AU - Persson,L A, AU - Juto,P, AU - Peltonen,M, AU - Suhr,O, AU - Hernell,O, PY - 1999/3/30/pubmed PY - 1999/3/30/medline PY - 1999/3/30/entrez SP - 63 EP - 8 JF - Journal of internal medicine JO - J. Intern. Med. VL - 245 IS - 1 N2 - OBJECTIVE: To determine the prevalence of coeliac disease in a population-based sample of Swedish adults. DESIGN: Population-based cross-sectional study. SETTING: Northern Sweden. SUBJECTS: A total of 1894 adults (76%) out of 2500 invited, randomly selected from the population register after stratification for age and sex. MAIN OUTCOME MEASURES: Prevalence of biopsy verified coeliac disease, symptoms of undiagnosed cases, and results of antiendomysium and antigliadin serum antibody tests. RESULTS: Coeliac disease was confirmed by intestinal biopsy showing enteropathy in 10 individuals (seven women and three men), corresponding to a prevalence of 5.3 per 1000 (95% CI = 2.5-9.7). The majority of cases (eight out of 10) had not been diagnosed prior to the screening, although many had symptoms compatible with coeliac disease. All individuals with antiendomysium antibody positivity who were subjected to a small intestinal biopsy had enteropathy. Furthermore, all of them also had elevated levels of antigliadin antibodies type IgA and/or IgG. CONCLUSIONS: Coeliac disease is common, albeit mostly undiagnosed, in Swedish adults. It is likely that the situation is no better in other countries. This highlights the importance of keeping coeliac disease in mind, and of promptly investigating individuals with unexplained, even mild, symptoms compatible with the disease. Serological markers, e.g. antigliadin and antiendomysium antibodies, are useful tools within this active case-finding strategy, although the final diagnosis should be based on an intestinal biopsy demonstrating enteropathy. SN - 0954-6820 UR - https://www.unboundmedicine.com/medline/citation/10095818/High_prevalence_of_undiagnosed_coeliac_disease_in_adults:_a_Swedish_population_based_study_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0954-6820&date=1999&volume=245&issue=1&spage=63 DB - PRIME DP - Unbound Medicine ER -