Advertising Disclaimer
Published online November 30, 2009
PEDIATRICS Vol. 124 No. 6 December 2009, pp. 1572-1578 (doi:10.1542/peds.2008-2373)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow View eLetters
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by McGowan, K. E.
Right arrow Articles by Butzner, J. D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by McGowan, K. E.
Right arrow Articles by Butzner, J. D.
Related Collections
Right arrow Gastrointestinal Tract
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ARTICLE

The Changing Face of Childhood Celiac Disease in North America: Impact of Serological Testing

Kelly E. McGowan, BHSc, Derek A. Castiglione, J. Decker Butzner, MD

Department of Pediatrics, University of Calgary, Calgary, Canada

OBJECTIVE: The goal was to evaluate the impact of immunoglobulin A endomysial antibody testing on the incidence and clinical presentation of childhood celiac disease.

METHODS: The incidence and clinical presentation of celiac disease in patients <18 years of age in 1990–1996 (pretesting group) versus 2000–2006 (testing group) were compared.

RESULTS: The median age at diagnosis was 2 years (95% confidence interval: 2–4 years) in the pretesting group (N = 36), compared with 9 years (95% confidence interval: 8–10 years) in the testing group (N = 199; P < .001); the female/male ratios (1.6:1) were similar (P = .982). The incidence of celiac disease increased from 2.0 cases per 100000 children (pretesting group) to 7.3 cases per 100000 children (testing group; P = .0256). The frequency of classic celiac disease presentations decreased from 67% (pretesting group) to 19% (testing group; P < .001), but the incidence of classic celiac disease did not differ (0.8 vs 1.6 cases per 100000; P = .154). In the testing group, 13 previously unrecognized clinical presentations were observed in 98 children, including 35 with family history, 18 with abdominal pain, and 14 with type 1 diabetes mellitus. The frequency of Marsh IIIc lesions decreased from 64% (pretesting group) to 44% (testing group; P = .0403). In the testing group, classic celiac disease remained predominant (67%) in young children (<3 years), whereas atypical gastrointestinal and silent presentations predominated in older children.

CONCLUSIONS: Antibody testing for celiac disease tripled the incidence of celiac disease and quadrupled the median age at diagnosis.

Key Words: celiac disease • epidemiology • clinical features • endomysial antibody • serological testing

Abbreviations: IgA—immunoglobulin A • EMA—endomysial antibody • CI—confidence interval • GFD—gluten-free diet

Accepted Jun 16, 2009.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


eLetters:

Read all eLetters

Dermatitis herpetiformis is the specific cutaneous manifestation of gluten sensitive enteropathy
Emiliano Antiga, et al.
Pediatrics Online, 14 Jan 2010 [Full text]