Celiac disease is uncommon in childhood. It is diagnosed in less than 1 in 2500 children in the United Kingdom.
In this study, physicians from Bristol, England, evaluated the prevalence of undiagnosed celiac disease in the general population at age 7.
The team studied 5470 children aged 7.5 years who were participating in a population based birth cohort study established in 1990.
The children underwent 2 stage screening. The first test was a sensitive radioimmunoassay for antibodies to tissue transglutaminase (endomysial antigen). Children who returned positive samples underwent serum IgA antiendomysial antibody (IgA-EMA) testing by indirect immunofluorescence.
Details of gastrointestinal symptoms and special diets were collected by routine questionnaire.
|50% of IgA-EMA positive children reported diarrhea.|
|British Medical Journal|
The physicians found that 1% of the children tested positive for IgA-EMA.
They established that IgA-EMA positive children were shorter and weighed less than those who tested negative.
The team also found that 50% of IgA-EMA positive children reported diarrhea, compared with 34% of tTG antibody negative.
Less than 0.1% of the children were reported to be on a gluten-free diet.
Dr Polly Bingley's team concluded, "The prevalence of celiac disease in these children is therefore comparable to that in UK adults".
"The benefit of early diagnosis of subclinical celiac disease remains unproven, but long term follow up of this cohort may help to resolve this".
"If screening is worth while, it should be started in childhood".
"Occult celiac disease seems to start in childhood, even in those who are subsequently diagnosed as adults."