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  • Jefferson Adams
    Jefferson Adams

    Prevalence of Celiac Disease in the Mediterranean Area

    Celiac.com 05/06/2011 - Recent epidemiological studies show that the prevalence of Celiac disease had been underestimated, affecting not only Europeans, but also populations of the Mediterranean countries, such as Middle East (1-4) and North Africa (5-7), where its prevalence is similar to that of Western countries.

    A international team of researchers recently set out to estimate the global burden related to undiagnosed Celiac Disease in the Mediterranean Area, as computed by morbidity, mortality and crude health cost.

    The team included Luigi Greco, Laura Timpone, Carmela Arcidiaco, Abkari Abdelhak, Attard Thomas, Barada Kassem, Bilbao Josè Ramon, Boudraa Ghazalia, Cullufi Paskal, Hugot Jean Pierre, Abu-Zekry Mona, Kuloglu Zarife, Roma Eleftheria, Shamir Raanan, Ter Terzic Selma, and Zrinjka MiÅ¡ak.

    Prevalence of celiac disease among low risk populations varies from 0.14% to 1.17% (15-17): 1%-1.3% in Turkey (18.19), 0.6%-0.96% in Iran (20-21), 0.5% in Egypt (22), 0.6% in Tunisia and Israel (23-24), <0.5% in Jordan, Lebanon, and Kuwait (1.10,16.25). Among high risk groups (patients with positive family history, insulin dependent diabetes mellitus, thyroiditis, etc.) the prevalence of celiac disease ranges from 2.4% to 44% assessed by serological markers and biopsy (26-27).

    The team discovered a celiac disease prevalence of 1%, an incidence, based on new Cases/year estimated on 1% of the live births of 1 in 7 symptomatic adults, and 1 in 5 children. Their results showed standardized mortality rate of 1.8 compared to age and sex matched population.

    They found that the delay between symptoms and diagnosis was six years for adults, and two years for children.

    The team found associated conditions in 10% of the total cohort (KB 30%: Turkey 2% Iran 33% , IDDM 10% (6.7-18.5%).

    Sixteen percent of symptomatic patients showed celiac disease-related complications.

    The team found the following non GI Symptoms among symptomatic patients: short stature 25% Anemia 40% (20-80%) Osteopenia 30% (30-50%), abnormal liver function 10% (Turkey 38%, Iran 25%).

    In the Northern Africa Region and in the Middle East very high incidence of celiac disease has recently been reported both in the general population and in at risk-group. These high frequencies are due to the wide consumption of wheat and barley and to the high frequency of the DR3-DQ2 celiac disease predisposing haplotypes in these population (13,14).

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  • About Me

    Jefferson Adams earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, science, and advanced research, and scientific methods. He previously served as Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

  • Related Articles

    Jefferson Adams
    Celiac.com 03/23/2011 - A group of researchers in India recently conducted a community-based study on the prevalence of celiac disease in the northern part of India.
    The research group included Govind K Makharia, Anil K Verma, Ritvik Amarchand, Shinjini Bhatnagar, Prasenjit Das, Anil Goswami, Vidyut Bhatia, Vineet Ahuja, Siddhartha Datta Gupta and Krishnan Anand.
    They are affiliated with the Departments of Gastroenterology and Human Nutrition, and Pediatrics and Pathology at the Centre for Community Medicine of the All India Institute of Medical Sciences in New Delhi.
    Worldwide celiac disease rates are estimated at about 1%, but the disease is thought to be uncommon in both India and Asia. However, there has generally been a lack of study data on the actual prevalence of celiac disease in Asian nations.
    The research team set out to accurately estimate the prevalence of celiac disease in a specific Indian community. The team crafted a cross sectional study to estimate rates of celiac disease in urban and rural populations in the National Capital Region, Delhi, India.
    The team gathered data using a structured questionnaire administered via door-to-door visits. The questionnaire provided socio-demographic data and basic screening for features of celiac disease, such as chronic or recurrent diarrhea, and anemia.
    For children, the questionnaire included additional factors, namely short stature (linear height below 5th percentile for age) and failure to thrive/gain weight.
    All test subjects with positive screens and 10% of negative screen individuals were called for anti-tissue transglutaminase antibody blood test.
    All those with positive blood tests were invited to undergo endoscopic biopsy. The team diagnosed celiac disease on the basis of a positive blood screens, the presence of villous atrophy and/or response to gluten free diet.
    The team contacted 12,573 people in all. A total of 10,488 (83.4%) (50.6% male) agreed to participate. Screening showed 5,622 (53.6%) positive results. Of those who screened positive, 2167 (38.5%) submitted to anti-tissue transglutaminase antibody blood tests. The team also tested 712 (14%) subjects who had tested negative.
    The data showed an overall sero-prevalence of celiac disease was 1.44% (95% conï¬dence interval [CI] 1.22 1.69) and the overall prevalence of celiac disease was 1.04% (95% CI 0.85 1.25).
    Celiac disease in this north Indian community is 1 in 96, or about 1%. That means that celiac disease is more common than is recognized in India, and that rates are about the same as in other parts of the world, not lower, as conventional wisdom has held.
    Source:

    Journal of Gastroenterology and Hepatology, March 2011 / DOI: 10.1111/j.1440-1746.2010.06606.x

    Tina Turbin
    Celiac Disease Prevalence is on the Rise
    Celiac.com 10/12/2011 - According to recent estimates, three million Americans suffer from celiac disease—approximately 1% of the population, and only three percent of them have to this writing been correctly diagnosed. As startling as that sounds to us all, according to a news article on Medscape Today, the incidence of celiac disease has increased markedly over the last three decades, perhaps even as fourfold, and studies are suggesting the incidence may actually be higher than 1% of the population.
    What is the reason for this? According to Dr. Jonas Ludvigsson, MD, from the Department of Medicine, Epidemiology Unit at the Karolinska Institute and Orebro University Hospital in Sweden, and a renowned celiac expert, there may be many factors explaining this, but there probably is an actual increase underlying these.
    The Medscape article went on to report that the Mayo Clinic has confirmed increase in celiac disease incidence, reported in Discovery's Edge, the Mayo Clinic's research magazine. Dr. Joseph Murray, MD, and colleagues analyzed stored blood samples from Air Force recruits in the early 1950s for gluten antibodies. It was assumed that 1% would be positive, given today's estimates, but the number of positive results was far smaller. Dr. Murray and his colleagues compared their results with two more recently collected sets with the conclusion that celiac disease is about four times more common today than it was in the 1950s.
    Additionally, Dr. Ludviggon's research team in Sweden has found that those living with celiac disease and latent celiac disease have higher mortality than those who don't have these conditions. Latent celiac disease is also known as "gluten sensitivity," a term to describe those who have "normal small intestinal mucosa but positive celiac disease serology," estimated to affect 1 in 1000 people. According to Dr. Ludvigsson's research team, in 1 year, 10 of 1000 individuals with celiac disease will die, as compared with 7 in 1000 individuals without the disease. The mortality rate is increased among those who also have latent celiac disease as well. The increased risk, however, is quite small.
    As alarming as the statistics are regarding the increasing rate of celiac disease, Dr. Ludvigsson shares some good news with Medscape—the methods of diagnosing celiac disease are actually improving. According to some other estimates, the rate of celiac diagnosis rate is increasing. For those who are testing positive for the celiac disease, the only method of treatment currently available is eliminating gluten from the diet. Yes, this is a simple treatment, although it can require some challenging lifestyle adjustments for the gluten-free community, something which I address in my work as an author, researcher, and gluten-free advocate. In the future, we may see other treatments such as gluten-digesting enzymes (which are on the rise) or even the genetic modification of the structure of gluten in wheat so that it will not cause an autoimmune reaction in celiac patients. Even with celiac diagnosis incidence on the rise, with raised awareness and effective diagnosis, we can help change the lives of millions of celiac Americans for the better. This is an important endeavor.


    Jefferson Adams
    Celiac.com 07/23/2012 - At 2012 Digestive Diseases Week in San Diego, California, Alvine Pharmaceuticals, Inc. announced the publication of data from Phase 2A trial of its main celiac disease compound, ALV003.
    The results show that ALV003, orally administered to celiac disease patients on a gluten free diet, significantly reduces gluten-triggered intestinal mucosal damage.
    For the trial, 41 adults with clinically proven celiac disease who had followed a gluten-free diet for at least one year were randomly given ALV003 or a placebo each day for six weeks. During that time, they also received 2g of gluten in the form of bread crumbs.
    Participants received a small bowel biopsy prior to randomization and again, at the end of the six week challenge.
    The results showed that the study met its primary endpoint of a clinically and statistically meaningful reduction in intestinal mucosal damage in celiac patients on a gluten-free diet. Damage was measured by the ratio of the villus height to crypt depth, or Vh:celiac disease between the ALV003 and placebo treated groups over the six week study period.
    Secondary endpoints included change in intraepithelial lymphocyte (IEL) density, gastrointestinal symptoms as measured by Gastrointestinal Symptom Rating Scale (GSRS) scores, celiac serologies, safety and tolerability.
    Each subject received small bowel biopsy at the start of the trial, and again after six weeks of daily gluten challenge.
    When researchers compared biopsy results from 34 patients, they found significantly less small intestinal mucosal damage in patients treated with ALV003 than in placebo-treated patients (p=0.013).
    Placebo-treated patients suffered worse damage and symptoms. Most often, these included abdominal distention, flatulence, eructation, abdominal pain and diarrhea.
    The published data shows that:
    Biopsy results for patients who received ALV003 had significantly reduced small intestinal mucosal damage compared with placebo-treated patients (p=0.0133). For placebo-treated patients, IELs, including CD3+ and CD3+ aB and subsets, which measure cellular inflammation responses, were significantly higher, but were mostly normal in the ALV003-treated patients. ALV003-treated patients had better overall GSRS scores and scores for indigestion and abdominal pain symptoms, compared with placebo-treated patients, though the results were not statistically significant. Patients reported no serious adverse events, however, placebo-treated patients reported more regular and consistent non-serious adverse. Such events that occurred in 10 percent or more patients included abdominal distention, flatulence, eructation, diarrhea, nausea, headache and fatigue. Celiac-disease blood tests revealed no significant changes between the ALV003 and placebo-treated patients, though results did show positive trends for tissue transglutaminase and deamidated gliadin peptide antibody titers in the ALV003-treated group, which indicates improved immune response. Daniel Adelman, M.D., Alvine's Senior Vice President and Chief Medical Officer, says that the trial results represent the first time that any such treatment for celiac disease has met its pre-specified primary endpoint of providing protection against damage from gluten-exposure in celiac disease patients, with data that is both clinically and statistically significant.
    Such a drug could help to protect gluten-free celiac disease patients against accidental gluten contamination.
    The company plans to initiate a Phase 2B trial later this year.
    Read the abstract of the presentation (Sa1342) on the DDW website. Review information on Alvine's current clinical trial titled "Evaluation of Patient Reported Outcome Instruments in Celiac Disease Patients" at the NIH website.

    Jefferson Adams
    Celiac.com 06/21/2013 - Caroline, a third-grader at St. Pius school in Chicago her mother, Cassandra, both have celiac disease.
    After being formally diagnosed at the Celiac Disease Center at the University of Chicago, they each received care package that contained "…lots of gluten free foods, as well as tons of literature about eating gluten free,” said Cassandra. “Caroline’s care package had a stuffed animal in it," she added.
    The university's care package program is funded solely by donations, and this knowledge, along with Caroline's appreciation, led to a desire to support the Celiac Disease Center.
    Cassandra credits Caroline with a plan to make and sell pony tail holders with ribbons. Caroline made the holders herself, and sold them for $4.00 each, collecting over one hundred dollars in the process.
    Caroline specifically "wanted the money to be used to send another little girl or boy a care package and stuffed animal,” said Cassandra.
    Caroline proudly announced her efforts and presented the money at her at her annual appointment with Dr. Stefano Guandalini, founder of the University of Chicago Celiac Disease Center.
    Dr. Guandalini was "so appreciative and proud of her efforts,” beamed Cassandra. “His kind words to her made our day, and Caroline left feeling great about giving back!”
    Principal Daniel Flaherty called Caroline a "…great example for all of us here at St. Pius X Parish School.”
    Source:
    http://www.chicagotribune.com/news/local/suburbs/lombard_villa_park/community/chi-ugc-article-st-pius-x-third-grader-inspired-to-give-2013-04-26,0,5389721.story

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    I think that there has been some mis-communication.   Every drug has risks and benefits.  I took strong does of antihistamines (both H1 and H2) as prescribed by my allergist (MD) because of chronic hives, not because I was suffering from gastric symptoms.  Could the use of them activated my third autoimmune disorder (Chronic Autoimmune Gastritis)?  Who knows?  But the horrible itching that kept me awake was unbearable.  These drugs helped.  This is an article that explains why: https:/
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