The epidemiology of coeliac disease in South Wales: a 28-year perspective

Whyte, Lisa; Jenkins, Huw

doi:10.1136/archdischild-2012-303113

Cited by 30 publications

(22 citation statements)

References 7 publications

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“…En la última década ha quedado claro que el número de pacientes celíacos conocidos es muy inferior al que está diagnosticado [11][12][13] . En buena parte esto se debe a que, anteriormente, la enfermedad se buscaba solamente en personas que se sentían enfermas y consultaban al médico.…”

Section: ¿En Quienes Debemos Buscar Enfermedad Celíaca?unclassified

Enfermedad celíaca. Una mirada actual

Araya

Bascuñán

2014

Rev. chil. pediatr.

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Catching up on celiac diseaseKnowledge about celiac disease continues to grow and amaze those who investigate, seek and treat this condition. Gone are the days when it was considered just a rare child's digestive disease. It is now recognized as a highly prevalent autoimmune condition that affects children and adults with digestive and extra-digestive symptoms of diverse intensity, disorder that may be either mono, oligo or asymptomatic from a digestive point of view. Today, it is an underdiagnosed condition, not actively considered, and often mistakes are made regarding its diagnosis, treatment and gluten-free diet monitoring. This article reviews the current definition of the disease, clinical presentations, potential patients, how to search for the disease, how the diagnosis is made and characteristics of the treatment and monitoring of celiac patients, all based on internationally agreed standards, and emphasizing those aspects that have proven to be useful in other countries regarding the management of the disease. resumen El conocimiento acerca de la enfermedad celíaca continúa creciendo y sorprendiendo a aquellos que la investigan, la buscan y la tratan. Lejos están los tiempos en que se la consideraba una patología digestiva del niño, poco frecuente. Actualmente se la reconoce como una condición autoinmune altamente prevalente, que afecta a niños y adultos, con manifestaciones digestivas y extra digestivas de muy diversa intensidad, pudiendo ser mono, oligo o incluso asintomática desde el punto de vista digestivo. Hoy en día está sub-diagnosticada, no se la busca activamente, se incurren en errores tanto al diagnosticarla como en la indicación del tratamiento y seguimiento de la dieta sin gluten. En este artículo revisamos la definición actual de la enfermedad, las presentaciones clínicas que se le conocen, en quiénes y cómo se debe buscar, como se hace el diagnóstico, y en qué consiste el tratamiento y seguimiento del paciente celíaco, basándonos en los criterios internacionales actualmente consensuados, y poniendo énfasis en aquellos aspectos que han demostrado ser útiles en otros paísespara mejorar el manejo de la enfermedad. (palabras clave: Enfermedad celíaca, clínica, búsqueda activa, dieta sin gluten). Rev Chil Pediatr 2014; 85 (6): 658-665 ACTUALIDAD Rev

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Section: ¿En Quienes Debemos Buscar Enfermedad Celíaca?unclassified

Enfermedad celíaca. Una mirada actual

Araya

Bascuñán

2014

Rev. chil. pediatr.

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“…During the epidemic period, the incidence rate of CD children detected clinically under the age of 2 years increased four-fold in comparison to the time period before (pre-epidemic period) and after (post-epidemic period) (Namatovu 2014). A plethora of studies indicates that the incidence rate of pediatric CD increased during the latest years, varying though worldwide a, Whyte 2013, Zingone 2015.…”

Section: Incidence and The Swedish Epidemic Of CDmentioning

confidence: 99%

“…Studies from various countries (Ludvigsson 2012, Whyte LA. 2013, White 2013, Namatovu 2014, Zingone F. 2015 confirm the increase of CD incidence rate during the recent years.…”

Section: Incidence Ratementioning

confidence: 99%

Demographics, clinical features and treatment of pediatric celiac disease

Tapsas¹

2015

Linköping University Medical Dissertations

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Celiac disease (CD) is a chronic small intestinal immune-mediated enteropathy triggered by ingestion of gluten-containing food in genetically predisposed subjects. The enteropathy is presented with a wide variety of clinical manifestations, which can occur even outside the gastrointestinal tract. In the majority of cases, the diagnosis of CD is based on a small intestinal biopsy showing mucosal alterations, i.e. intraepithelial lymphocytosis, crypt hyperplasia, and villous atrophy. The treatment, gluten-free diet (GFD), has recently been revised with the addition of gluten-free oats. Oats give a more diversified nutrition and increase the fibre content. The use of oats in CD is though still debated in some reports. A strict life-long adherence to the GFD can be problematic, especially for pediatric CD patients. Sweden reported of one of the highest observed CD prevalences worldwide, i.e. 3%, among 12-year-olds born during what has been described as "the Swedish celiac epidemic", 1984−1996.The aims of this thesis were to elucidate how pediatric CD has changed during a 41-year period in Sweden, i.e. 1973Sweden, i.e. −2013, in terms of clinical presentation, disease severity, incidence, and demographics. We also wanted to adress the compliance to the GFD, the use of oats in the GFD and the safety of oats inclusion in the diet by measuring urinary nitric oxide (NO) metabolites.Filed information provided data about 2856 pediatric patients investigated for suspected CD between 1973 and 2013; of which 1030 patients were diagnosed with CD. After the data analyses the mean age of CD patients was shown to increase after the celiac epidemic period.Currently, CD shows a less severe picture in terms of symptoms and intestinal pathology.Younger children suffer primarily from gastrointestinal symptoms and growth failure, whereas extra-intestinal manifestations are more often displayed among adolescents. viWe also reported an unusually high pediatric CD incidence rate and cumulative incidence, likely the highest reported worldwide. We hypothesised that the introduction of new antibody tests would affect the diagnostic activity and accuracy in performing small intestinal biopsies for CD investigation. However, the outcome of diagnostic activity and accuracy could not clearly be attributed to the use of antibody tests due to changes occurring in parallel during the 41-year study period, e.g. a different pattern of symptoms at presentation and improved knowledge of the disease among parents and health professionals.In a questionnaire-based study our patient group reported a high compliance to the GFD.Long duration of the GFD may, however, influence compliance negatively. Oats have been included to the GFD of our study population in most of the cases without reporting major complications related to their well-being.The urinary measurements of NO metabolites revealed two patient groups, one with high and one with low levels. The two populations did not differ regarding sex, age, compliance to the GFD or oats consumption. Fa...

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“…There are substantially fewer paediatric gastroenterologists than adult specialists, in the UK and across Europe. There has also been an increase in demand for paediatric endoscopy, not only due to the increase in recognition of children with coeliac disease, 5 but also to increasing numbers of children requiring endoscopy for inflammatory bowel disease and emerging disorders such as eosinophilic oesophagitis. Therefore publication of studies that demonstrated that a high titre of IgA tTG antibodies accurately predicted the finding of diagnostic histological changes on biopsy were important.…”

Section: Coeliac Disease: a Common Disordermentioning

confidence: 99%

“…There has therefore been a shift towards recognition of people with more subtle symptoms, but even now around 80% of cases remain unrecognised in both adults and children compared with what would be expected in a screening programme. 5 The long-term consequences of truly asymptomatic coeliac disease are unknown, and, as such, population screening is not yet indicated. However, the challenge is to identify people with active coeliac disease but relatively subtle symptoms.…”

Section: Coeliac Disease: a Common Disordermentioning

confidence: 99%