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PEDIATRICS Vol. 107 No. 1 January 2001, pp. 42-45

Serological Screening for Celiac Disease in Healthy 2.5-Year-Old Children in Sweden

Received Nov 18, 1999; accepted May 24, 2000.

Anneli K. Carlsson*, Irene E. M. Axelsson*, Stefan K. Borulf*, Anders C. A. BredbergDagger , and Sten-A. Ivarsson*

From the Departments of * Pediatrics and Dagger  Medical Microbiology, University of Lund, University Hospital, Malmö, Sweden.

Objective.  The study was designed to investigate the prevalence of celiac disease (CD) among 2.5-year-old children in a Swedish urban population with a high incidence of CD.

Material and Methods.  Six hundred ninety apparently healthy children, born in the 12-month period of July 1992 through June 1993, were screened for immunoglobulin A (IgA) antigliadin antibodies and IgA antiendomysium antibodies, and those antibody-positive at repeated testing were further investigated with intestinal biopsy.

Results.  Of the 690 children, 6 were both IgA antigliadin antibody- and IgA antiendomysium antibody-positive, and 7 were antiendomysium antibody-positive but antigliadin antibody-negative. Jejunal biopsy, performed in 12 cases, manifested partial or total villous atrophy in 8 cases. Thus, together with an additional child whose parents declined the offered biopsy, but whose response to a gluten-free diet confirmed the presence of CD, the prevalence of CD in the study series was 1.3% (9/690; 95% confidence interval: .4-2.2). However, independent of the study, an additional 22 cases of symptomatic, biopsy-verified CD have already been detected in the birth cohort of 3004 children.

Conclusions.  The prevalence of CD in our study series was high, at least 1.0%, but may be as high as 2.0% if the frequency of silent CD is as high as we have found in the remaining unscreened cohort. These findings confirm that CD is one of the most common chronic disorders.  Key words:  celiac disease, immunoglobulin A antigliadin antibodies, immunoglobulin A antiendomysium antibodies.




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