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Population screening for coeliac disease in a low prevalence area in Italy.
Scand J Gastroenterol 2006; 41(12):1414-20SJ

Abstract

OBJECTIVE

A screening program was proposed for the village of Carcare (population 5700), located in a region of Italy with an apparently low prevalence of coeliac disease (CD): only 1 patient diagnosed out of 2557 inhabitants. The study group comprised 1002 individuals (568 F, 434 M, age range 13-90 years) recruited from blood donors, secondary school pupils and people referred to the local outpatient facilities for routine blood chemistry.

MATERIAL AND METHODS

Total IgA, IgA anti-tissue transglutaminase (tTG) (ELISA, recombinant human antigen) and IgA antiendomysium (EMA) (IFI, umbilical cord substrate) antibodies were measured in the serum of all participants. All patients with IgA deficiency were investigated for IgG tTG antibodies, and in the case of disagreement between tTG and EMA, they were typed for HLA DQ2-DQ8 haplotypes.

RESULTS

Thirteen subjects were positive and 988 negative for autoantibodies (3/988 had IgA deficiency). One serum sample was positive for tTG antibodies but negative for EMA. Ten out of 13 positive subjects consented to undergo duodenal biopsy, which invariably produced evidence of CD despite the absence of clinical signs/symptoms. A post-diagnostic clinical investigation provided evidence showing mild iron deficiency (4 subjects) and osteoporosis (2 subjects). After counselling, all subjects accepted a gluten-free diet.

CONCLUSIONS

The prevalence of CD in the study group was 1:100 (1.0%; 95% CI: 0.5-1.8%): this indicates that CD is largely underdiagnosed in Carcare. Our results suggest that the low prevalence of CD observed in some regions is likely to be due to underdiagnosis.

Authors+Show Affiliations

Medicina Interna II ASL2 Savona, Ospedale S.Paolo, Savona, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo 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

17101572

Citation

Menardo, Giorgio, et al. "Population Screening for Coeliac Disease in a Low Prevalence Area in Italy." Scandinavian Journal of Gastroenterology, vol. 41, no. 12, 2006, pp. 1414-20.
Menardo G, Brizzolara R, Bonassi S, et al. Population screening for coeliac disease in a low prevalence area in Italy. Scand J Gastroenterol. 2006;41(12):1414-20.
Menardo, G., Brizzolara, R., Bonassi, S., Marchetti, A., Dante, G. L., Pistone, C., ... Pesce, G. (2006). Population screening for coeliac disease in a low prevalence area in Italy. Scandinavian Journal of Gastroenterology, 41(12), pp. 1414-20.
Menardo G, et al. Population Screening for Coeliac Disease in a Low Prevalence Area in Italy. Scand J Gastroenterol. 2006;41(12):1414-20. PubMed PMID: 17101572.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Population screening for coeliac disease in a low prevalence area in Italy. AU - Menardo,Giorgio, AU - Brizzolara,Renata, AU - Bonassi,Stefano, AU - Marchetti,Alessandro, AU - Dante,Gian Luigi, AU - Pistone,Cristina, AU - Marenco,Donatella, AU - Rabellino,Viviana, AU - Buscaglia,Sandra, AU - Scarso,Rita, AU - Murialdo,Mauro, AU - Venturino,Ezio, AU - Marino,Carla Enrica, AU - Descalzi,Desideria, AU - Minetti,Franca, AU - Bagnasco,Marcello, AU - Pesce,Giampaola, PY - 2006/11/15/pubmed PY - 2007/3/17/medline PY - 2006/11/15/entrez SP - 1414 EP - 20 JF - Scandinavian journal of gastroenterology JO - Scand. J. Gastroenterol. VL - 41 IS - 12 N2 - OBJECTIVE: A screening program was proposed for the village of Carcare (population 5700), located in a region of Italy with an apparently low prevalence of coeliac disease (CD): only 1 patient diagnosed out of 2557 inhabitants. The study group comprised 1002 individuals (568 F, 434 M, age range 13-90 years) recruited from blood donors, secondary school pupils and people referred to the local outpatient facilities for routine blood chemistry. MATERIAL AND METHODS: Total IgA, IgA anti-tissue transglutaminase (tTG) (ELISA, recombinant human antigen) and IgA antiendomysium (EMA) (IFI, umbilical cord substrate) antibodies were measured in the serum of all participants. All patients with IgA deficiency were investigated for IgG tTG antibodies, and in the case of disagreement between tTG and EMA, they were typed for HLA DQ2-DQ8 haplotypes. RESULTS: Thirteen subjects were positive and 988 negative for autoantibodies (3/988 had IgA deficiency). One serum sample was positive for tTG antibodies but negative for EMA. Ten out of 13 positive subjects consented to undergo duodenal biopsy, which invariably produced evidence of CD despite the absence of clinical signs/symptoms. A post-diagnostic clinical investigation provided evidence showing mild iron deficiency (4 subjects) and osteoporosis (2 subjects). After counselling, all subjects accepted a gluten-free diet. CONCLUSIONS: The prevalence of CD in the study group was 1:100 (1.0%; 95% CI: 0.5-1.8%): this indicates that CD is largely underdiagnosed in Carcare. Our results suggest that the low prevalence of CD observed in some regions is likely to be due to underdiagnosis. SN - 0036-5521 UR - https://www.unboundmedicine.com/medline/citation/17101572/Population_screening_for_coeliac_disease_in_a_low_prevalence_area_in_Italy_ L2 - http://www.tandfonline.com/doi/full/10.1080/00365520600815605 DB - PRIME DP - Unbound Medicine ER -