Little is known about the prevalence and burden of undiagnosed celiac disease in individuals younger than age 50.
Dr Joseph Murray and colleagues determined the prevalence and morbidity of undiagnosed celiac disease in individuals younger than age 50 in a community.
The team tested sera from 31,255 residents of Olmsted County, Minnesota, without a prior diagnosis of celiac disease assay using an assay for IgA against tissue transglutaminase.
In subjects with positive test results, celiac disease was confirmed using an assay for endomysial IgA.
The researchers performed a nested case–control study to compare the proportion of comorbidities between undiagnosed cases of celiac disease and age- and sex-matched seronegative controls.
Medical records were abstracted to identify potential comorbidities.
|The prevalence of undiagnosed celiac disease is about 1%|
The researchers identified 338 of 30,425 adults with positive results from both serologic tests.
Based on this finding, the research team estimated the prevalence of celiac disease to be 1%; 8 of 830 children tested positive for IgA against tissue transglutaminase.
The team found that no typical symptoms or classic consequences of diagnosed celiac disease were associated with undiagnosed celiac disease.
Undiagnosed celiac disease was associated with increased rates of hypothyroidism, and a lower than average cholesterol level, and ferritin level.
The researchers noted that during a median follow-up period of 6 years, the cumulative incidence of a subsequent diagnosis with celiac disease at 5 years after testing was 11% in persons with undiagnosed celiac disease vs 0.1% in seronegative persons.
The team found that celiac disease status was not associated with overall survival.
Dr Murray's team commented, "Based on serologic tests of a community population for celiac disease, we estimated the prevalence of undiagnosed celiac disease to be 1%."
"Undiagnosed celiac disease appeared to be clinically silent and remained undetected, but long-term outcomes have not been determined."