The Smaller Size of the ‘Coeliac Iceberg’ in Adults

G. R. Corazza Dept. of Internal Medicine, University of L'Aquila, L'Aquila; ‘Marcello Boldrini’ Institute of Statistical and Mathematical Science, University of Milan, Milan; Medical Clinic, Catholic University, Rome, Italy; Division of General Medicine, Institute of Social Security, San Marino, Republic of San Marino, Rome, Italy

M. L. Andreani Dept. of Internal Medicine, University of L'Aquila, L'Aquila; ‘Marcello Boldrini’ Institute of Statistical and Mathematical Science, University of Milan, Milan; Medical Clinic, Catholic University, Rome, Italy; Division of General Medicine, Institute of Social Security, San Marino, Republic of San Marino, Rome, Italy

F. Biagi Dept. of Internal Medicine, University of L'Aquila, L'Aquila; ‘Marcello Boldrini’ Institute of Statistical and Mathematical Science, University of Milan, Milan; Medical Clinic, Catholic University, Rome, Italy; Division of General Medicine, Institute of Social Security, San Marino, Republic of San Marino, Rome, Italy

G. Corrao Dept. of Internal Medicine, University of L'Aquila, L'Aquila; ‘Marcello Boldrini’ Institute of Statistical and Mathematical Science, University of Milan, Milan; Medical Clinic, Catholic University, Rome, Italy; Division of General Medicine, Institute of Social Security, San Marino, Republic of San Marino, Rome, Italy

S. Pretolani Dept. of Internal Medicine, University of L'Aquila, L'Aquila; ‘Marcello Boldrini’ Institute of Statistical and Mathematical Science, University of Milan, Milan; Medical Clinic, Catholic University, Rome, Italy; Division of General Medicine, Institute of Social Security, San Marino, Republic of San Marino, Rome, Italy

G. Giulianelli Dept. of Internal Medicine, University of L'Aquila, L'Aquila; ‘Marcello Boldrini’ Institute of Statistical and Mathematical Science, University of Milan, Milan; Medical Clinic, Catholic University, Rome, Italy; Division of General Medicine, Institute of Social Security, San Marino, Republic of San Marino, Rome, Italy

G. Ghironzi Dept. of Internal Medicine, University of L'Aquila, L'Aquila; ‘Marcello Boldrini’ Institute of Statistical and Mathematical Science, University of Milan, Milan; Medical Clinic, Catholic University, Rome, Italy; Division of General Medicine, Institute of Social Security, San Marino, Republic of San Marino, Rome, Italy

G. Gasbarrini Dept. of Internal Medicine, University of L'Aquila, L'Aquila; ‘Marcello Boldrini’ Institute of Statistical and Mathematical Science, University of Milan, Milan; Medical Clinic, Catholic University, Rome, Italy; Division of General Medicine, Institute of Social Security, San Marino, Republic of San Marino, Rome, Italy

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Abstract

Background: Since it has been ascertained that the prevalence of coeliac disease in the general paediatric population is 3.3 per 1000, we decided to evaluate this prevalence in the general adult population. Methods: Two thousand two hundred and thirty-seven adult subjects aged 20-87 years, representative of a population with sociodemographic characteristics typical of Western European countries with regard to sex and age, were studied. In all serum IgA antiendomysial antibodies (EMA) were searched for, and all patients who turned out to be positive underwent intestinal biopsy. Results: Four symptomless subjects aged between 20 and 39 years proved positive at the IgA EMA screening. The intestinal biopsy confirmed coeliac disease in all of them. The prevalence in our study group was, therefore, 1.8 per 1000. Conclusions: This study shows that the size of the submerged part of the ‘coeliac iceberg’ is perhaps smaller in the adult population and suggests a linear trend towards a lower coeliac disease prevalence as age increases.

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The Smaller Size of the ‘Coeliac Iceberg’ in Adults

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