High prevalence of undiagnosed coeliac disease in adults: a Swedish population-based study
Article first published online: 25 DEC 2001
1999 Blackwell Science Ltd
Journal of Internal Medicine
Volume 245, Issue 1, pages 63–68, January 1999
How to Cite
IVARSSON, A., Persson, L. Å., Juto, P., Peltonen, M., Suhr, O. and Hernell, O. (1999), High prevalence of undiagnosed coeliac disease in adults: a Swedish population-based study. Journal of Internal Medicine, 245: 63–68. doi: 10.1046/j.1365-2796.1999.00403.x
- Issue published online: 25 DEC 2001
- Article first published online: 25 DEC 2001
- coeliac disease;
Objective. To determine the prevalence of coeliac disease in a population-based sample of Swedish adults.
Design. Population-based cross-sectional study.
Setting. Northern Sweden.
Subjects. A total of 1894 adults (76%) out of 2500 invited, randomly selected from the population register after stratification for age and sex.
Main outcome measures. Prevalence of biopsy verified coeliac disease, symptoms of undiagnosed cases, and results of antiendomysium and antigliadin serum antibody tests.
Results. Coeliac disease was confirmed by intestinal biopsy showing enteropathy in 10 individuals (seven women and three men), corresponding to a prevalence of 5.3 per 1000 (95% CI = 2.5–9.7). The majority of cases (eight out of 10) had not been diagnosed prior to the screening, although many had symptoms compatible with coeliac disease. All individuals with antiendomysium antibody positivity who were subjected to a small intestinal biopsy had enteropathy. Furthermore, all of them also had elevated levels of antigliadin antibodies type IgA and/or IgG.
Conclusions. Coeliac disease is common, albeit mostly undiagnosed, in Swedish adults. It is likely that the situation is no better in other countries. This highlights the importance of keeping coeliac disease in mind, and of promptly investigating individuals with unexplained, even mild, symptoms compatible with the disease. Serological markers, e.g. antigliadin and antiendomysium antibodies, are useful tools within this active case-finding strategy, although the final diagnosis should be based on an intestinal biopsy demonstrating enteropathy.