Dr. Alexander: In reviewing the syllabus for the Baltimore conference, there are some points that I wonder about. The syllabus suggests the frequency of celiac disease (celiac disease) may be 1 in 250 people. Perhaps it is in Ireland and certain other locations where there is a homogenous population this may be true. But could it really be 1 in 250 people in Italy, which is practically synonymous with pasta? You would expect there to be an epidemic of complications. Perhaps the definition of celiac disease used in these studies is less stringent than it is here. If the studies are based on symptoms or positive blood tests, they could be including a lot of false positives in their statistics. Or perhaps the studies are based on relatives of celiacs, in which case you would pick up a higher percentage of celiacs than you would from the general population.