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Increasing prevalence of coeliac disease in Swedish children: influence of feeding recommendations, serological screening and small intestinal biopsy activity.
Scand J Gastroenterol 2004; 39(10):946-52SJ

Abstract

BACKGROUND

The prevalence of coeliac disease (CD) in Swedish children has attracted considerable interest over the past few decades, and especially the influence of feeding habits on the increased incidence. A national study has reported a trend towards a decrease in incidence after a change in infant feeding recommendations was introduced in 1996. The aim of this study was to evaluate, in a geographically defined area, the change in incidence with time and the influence of the introduction of antibody analysis.

METHODS

Cases of suspected paediatric CD between 1980 and 2003 were studied for prevalence, biopsy findings and antibody analyses.

RESULTS

A total of 2029 children were investigated by small intestinal biopsy, yielding 554 CD cases. The area initially showed the same trend as the national study, but the annual incidence rate is now increasing again. Median age at diagnosis has increased significantly since 1997 from less than 2 years of age to above 5 years. Cumulative incidence at 2 years of age is much higher for the birth cohorts 1983-96 than 1980-82 or 1997-2001. Diagnostic accuracy was significantly higher after the introduction of antigliadin (AGA) analysis, and especially after antiendomysium (EMA) analysis.

CONCLUSIONS

The incidence rate of CD in small children in our region has varied widely over the 24-year period observed. Feeding practice and methods of investigation have changed during this period. The annual incidence rate for the total child population in 2003 was almost equal to the peak value observed in 1994. There were no conclusive results on whether antibody analysis had an influence on diagnostic activity, but this seems to have increased diagnostic accuracy.

Authors+Show Affiliations

Division of Paediatrics, Department of Molecular and Clinical Medicine, IMK, Linköpings Universitet, Sweden. pia.laurin@swipnet.seNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

15513333

Citation

Laurin, P, et al. "Increasing Prevalence of Coeliac Disease in Swedish Children: Influence of Feeding Recommendations, Serological Screening and Small Intestinal Biopsy Activity." Scandinavian Journal of Gastroenterology, vol. 39, no. 10, 2004, pp. 946-52.
Laurin P, Stenhammar L, Fälth-Magnusson K. Increasing prevalence of coeliac disease in Swedish children: influence of feeding recommendations, serological screening and small intestinal biopsy activity. Scand J Gastroenterol. 2004;39(10):946-52.
Laurin, P., Stenhammar, L., & Fälth-Magnusson, K. (2004). Increasing prevalence of coeliac disease in Swedish children: influence of feeding recommendations, serological screening and small intestinal biopsy activity. Scandinavian Journal of Gastroenterology, 39(10), pp. 946-52.
Laurin P, Stenhammar L, Fälth-Magnusson K. Increasing Prevalence of Coeliac Disease in Swedish Children: Influence of Feeding Recommendations, Serological Screening and Small Intestinal Biopsy Activity. Scand J Gastroenterol. 2004;39(10):946-52. PubMed PMID: 15513333.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increasing prevalence of coeliac disease in Swedish children: influence of feeding recommendations, serological screening and small intestinal biopsy activity. AU - Laurin,P, AU - Stenhammar,L, AU - Fälth-Magnusson,K, PY - 2004/10/30/pubmed PY - 2005/2/3/medline PY - 2004/10/30/entrez SP - 946 EP - 52 JF - Scandinavian journal of gastroenterology JO - Scand. J. Gastroenterol. VL - 39 IS - 10 N2 - BACKGROUND: The prevalence of coeliac disease (CD) in Swedish children has attracted considerable interest over the past few decades, and especially the influence of feeding habits on the increased incidence. A national study has reported a trend towards a decrease in incidence after a change in infant feeding recommendations was introduced in 1996. The aim of this study was to evaluate, in a geographically defined area, the change in incidence with time and the influence of the introduction of antibody analysis. METHODS: Cases of suspected paediatric CD between 1980 and 2003 were studied for prevalence, biopsy findings and antibody analyses. RESULTS: A total of 2029 children were investigated by small intestinal biopsy, yielding 554 CD cases. The area initially showed the same trend as the national study, but the annual incidence rate is now increasing again. Median age at diagnosis has increased significantly since 1997 from less than 2 years of age to above 5 years. Cumulative incidence at 2 years of age is much higher for the birth cohorts 1983-96 than 1980-82 or 1997-2001. Diagnostic accuracy was significantly higher after the introduction of antigliadin (AGA) analysis, and especially after antiendomysium (EMA) analysis. CONCLUSIONS: The incidence rate of CD in small children in our region has varied widely over the 24-year period observed. Feeding practice and methods of investigation have changed during this period. The annual incidence rate for the total child population in 2003 was almost equal to the peak value observed in 1994. There were no conclusive results on whether antibody analysis had an influence on diagnostic activity, but this seems to have increased diagnostic accuracy. SN - 0036-5521 UR - https://www.unboundmedicine.com/medline/citation/15513333/Increasing_prevalence_of_coeliac_disease_in_Swedish_children:_influence_of_feeding_recommendations_serological_screening_and_small_intestinal_biopsy_activity_ L2 - http://www.tandfonline.com/doi/full/10.1080/00365520410003380 DB - PRIME DP - Unbound Medicine ER -