Mass screening in school-age children has led to the diagnosis of far more cases of celiac disease, according to a new study presented yesterday at the 6th World Congress of Gastroenterology, Hepatology and Pediatric Nutrition.
A research team in Italy found twice as many cases of celiac disease (an autoimmune disease in which the body makes antibodies to gluten) in school-aged children compared to a similar study conducted by the same group 25 years ago.
Celiac disease doubled
The new screening program involved 7.760 children aged between 5 and 11 in eight Italian provinces. And found that the overall prevalence of celiac disease was of 1,6%, much higher than the approximately 1% of the world's population believed to have the condition.
The children were screened with a fingertip blood test. The researchers focused on mutations in the human leukocyte antigens (HLA). It is what predisposes a child to developing celiac disease. If they tested positive, the children were then checked for gluten antibodies. The diagnosis is then confirmed using the European Society for Pediatric, Gastroenterology, Hepatology and Nutrition (ESPGHAN) criteria.
More screening, more diagnosis
The lead author of the multicenter CELI SCREEN study, Dr Elena Lionetti, stresses the importance of child screening. It allows you to diagnose more cases of celiac disease than the standard crossroads (which involves testing children only for symptoms or a family history of the disease).
The prevalence of celiac disease in schoolchildren has doubled over the past 25 years. Our view is that there are more cases of celiac disease than in the past and that we could not detect them without a screening strategy.
Female doctor Elena Lionetti
What is celiac disease?
Celiac disease is caused by the body producing antibodies against gluten. It is a very common protein, used to produce foods including bread, pasta, biscuits, cakes and some breakfast cereals. Antibodies damage the intestinal lining causing bloating, pain, diarrhea, anemia, and other conditions. In infants and children, celiac disease can cause abdominal pain, bloating, and vomiting, as well as lead to poor growth and delayed puberty. Celiac disease is one of the most common lifelong conditions in European countries. Following a strictly gluten-free diet is an effective treatment: it causes the symptoms to disappear and the intestinal damage to gradually heal.
Celiac disease, a growing wave
'At the moment,' says Lionetti, '70% of celiac patients are undiagnosed. If screening were performed during childhood in non-invasive ways, damage to the intestinal villi could potentially be prevented. They can lead to growth problems, fatigue and early osteoporosis."
Commenting on the research, Tunde Koltai, president of the AOECS (Association of European Celiac Societies) added: “This new study adds to the growing evidence base. Those that celiac disease is growing in Europe. We need to adopt childhood screening to give the population the best possible quality of life."
