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Serologic Testing Has Changed Celiac Disease Presentation

Screening diagnoses one in four cases, with many cases asymptomatic

TUESDAY, Dec. 19 (HealthDay News) -- Over the past 20 years, celiac disease diagnoses in children have increased and become less likely to be based on symptoms, with almost one in four cases diagnosed only with targeted screening, according to a study conducted in the United Kingdom. The report is published in the December issue of the Archives of Disease in Childhood.

Huw R. Jenkins, M.D., of University Hospital of Wales in Cardiff, and colleagues conducted a 21-year review of prospective data and compared presenting features from the past five years to those of the previous 16 years. No serologic testing was used between 1983 and 1989, antigliadin antibody was used from 1990 through 1998 and antitissue transglutaminase was used from 1999 on.

Of the 86 cases diagnosed, 50 were between 1999 and 2004, 25 between 1990 and 1998, and 11 between 1983 and 1989. The median age at diagnosis was 8 years in the past five years compared to 7.5 years of age between 1990 and 1998, and 4 years of age from 1983 through 1989. Gastrointestinal symptoms have significantly lessened throughout the study period, and almost one in four cases are diagnosed by targeted screening.

"Almost one in four children with celiac disease is now diagnosed by targeted screening. Most children with celiac disease remain undiagnosed," the authors write. "Pediatricians and primary care physicians should keep the possibility of celiac disease in mind and have a low threshold for testing, so that the potential long-term problems associated with untreated celiac disease can be prevented," they conclude.

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