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The use of a single serological marker underestimates the prevalence of celiac disease in Israel: a study of blood donors.
Am J Gastroenterol 2002; 97(10):2589-94AJ

Abstract

OBJECTIVES

Recent studies suggest that celiac disease was previously underdiagnosed. To find out whether antiendomysial antibodies underestimate the prevalence of celiac disease, we elected to use a strategy combining multiple serological markers to explore the prevalence of celiac disease in Israel and the usefulness of the various antibodies in screening for celiac disease.

METHODS

Serum samples from 1571 healthy blood donors were tested. A small intestinal biopsy was offered to all patients who tested positive for either human tissue transglutaminase antibodies, an ELISA kit based on antiendomysium (EMA-ELISA), immunoglobulin A antigliadin verified by antiendomysial immunofluorescence antibodies, and to patients who were IgA deficient with elevated antigliadin IgG.

RESULTS

A total of 59 subjects (3.8% of study population) were offered an intestinal biopsy based on serological findings, and 30 of 59 patients agreed to undergo intestinal biopsy (1.9% of study population). Celiac disease was diagnosed in 10 patients, establishing a prevalence of at least 1:157 in the general population (0.6%, CI = 0.3-1.1%). Using any serological marker alone would have underestimated the prevalence of celiac disease, as it was diagnosed in only two patients who tested positive for endomysial immunofluorescence antibodies (prevalence of 1:786, 0.1%, CI = 0.02-0.5%), six patients positive for tissue transglutaminase (prevalence of 1:262, 0.4%, CI = 0.1-0.9%), and seven patients positive for ELISA-EMA (prevalence of 1:224, 0.45%, CI = 0.2-0.9%).

CONCLUSIONS

The prevalence of celiac disease in Israel is at least 1:157 in the general population, confirming its underdiagnosis in previous studies. The disparity between the various serological markers suggest that the use of one serological marker is insufficient for establishing the true prevalence of celiac disease.

Authors+Show Affiliations

Department of Pediatrics, Rambam Medical Center, Haifa, Israel.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12385444

Citation

Shamir, Raanan, et al. "The Use of a Single Serological Marker Underestimates the Prevalence of Celiac Disease in Israel: a Study of Blood Donors." The American Journal of Gastroenterology, vol. 97, no. 10, 2002, pp. 2589-94.
Shamir R, Lerner A, Shinar E, et al. The use of a single serological marker underestimates the prevalence of celiac disease in Israel: a study of blood donors. Am J Gastroenterol. 2002;97(10):2589-94.
Shamir, R., Lerner, A., Shinar, E., Lahat, N., Sobel, E., Bar-or, R., ... Eliakim, R. (2002). The use of a single serological marker underestimates the prevalence of celiac disease in Israel: a study of blood donors. The American Journal of Gastroenterology, 97(10), pp. 2589-94.
Shamir R, et al. The Use of a Single Serological Marker Underestimates the Prevalence of Celiac Disease in Israel: a Study of Blood Donors. Am J Gastroenterol. 2002;97(10):2589-94. PubMed PMID: 12385444.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The use of a single serological marker underestimates the prevalence of celiac disease in Israel: a study of blood donors. AU - Shamir,Raanan, AU - Lerner,Aaron, AU - Shinar,Eilat, AU - Lahat,Nitza, AU - Sobel,Esther, AU - Bar-or,Rina, AU - Kerner,Hedviga, AU - Eliakim,Rami, PY - 2002/10/19/pubmed PY - 2002/11/26/medline PY - 2002/10/19/entrez SP - 2589 EP - 94 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 97 IS - 10 N2 - OBJECTIVES: Recent studies suggest that celiac disease was previously underdiagnosed. To find out whether antiendomysial antibodies underestimate the prevalence of celiac disease, we elected to use a strategy combining multiple serological markers to explore the prevalence of celiac disease in Israel and the usefulness of the various antibodies in screening for celiac disease. METHODS: Serum samples from 1571 healthy blood donors were tested. A small intestinal biopsy was offered to all patients who tested positive for either human tissue transglutaminase antibodies, an ELISA kit based on antiendomysium (EMA-ELISA), immunoglobulin A antigliadin verified by antiendomysial immunofluorescence antibodies, and to patients who were IgA deficient with elevated antigliadin IgG. RESULTS: A total of 59 subjects (3.8% of study population) were offered an intestinal biopsy based on serological findings, and 30 of 59 patients agreed to undergo intestinal biopsy (1.9% of study population). Celiac disease was diagnosed in 10 patients, establishing a prevalence of at least 1:157 in the general population (0.6%, CI = 0.3-1.1%). Using any serological marker alone would have underestimated the prevalence of celiac disease, as it was diagnosed in only two patients who tested positive for endomysial immunofluorescence antibodies (prevalence of 1:786, 0.1%, CI = 0.02-0.5%), six patients positive for tissue transglutaminase (prevalence of 1:262, 0.4%, CI = 0.1-0.9%), and seven patients positive for ELISA-EMA (prevalence of 1:224, 0.45%, CI = 0.2-0.9%). CONCLUSIONS: The prevalence of celiac disease in Israel is at least 1:157 in the general population, confirming its underdiagnosis in previous studies. The disparity between the various serological markers suggest that the use of one serological marker is insufficient for establishing the true prevalence of celiac disease. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/12385444/The_use_of_a_single_serological_marker_underestimates_the_prevalence_of_celiac_disease_in_Israel:_a_study_of_blood_donors_ L2 - http://Insights.ovid.com/pubmed?pmid=12385444 DB - PRIME DP - Unbound Medicine ER -