“…In studies of incidence rates in males, the rates increased up to the 60-to 80-year age band in most studies [13,[15][16][17][18][19][20][21][22][23][24][25] , with 2 showing an increase to the 40-year age band [26,27] and 2 reporting fluctuations in rate with age but an overall increase [28,29] . In females, there was more fluctuation in incidence rates with age with some studies showing a peak in incidence at 20-40 years and then a second one at 50-70 years [15, 17, 19-23, 26, 27, 29] , others just had a peak in incidence in the latter age band [13,18,24] . In some studies [13,20,22,25,29,30] the incidence in the elderly (65 or 70 years upwards) was reported to be 0/1,000,000/year, which indicates possible underdiagnosing or misdiagnosing of patients in this group [20,30] .…”