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    Scott Adams
    Scott Adams

    By Scott Adams •

    Celiac Disease in the Year 2000: Exploring the Iceberg

    Reviewed and edited by a celiac disease expert.

    Abstract for the Italian study:
    Catassi C; Ratsch IM; Fabiani E; Rossini M; Bordicchia F; Candela F; Coppa GV; Giorgi PL
    Coeliac Disease in the Year 2000: Exploring the Iceberg [see comments]
    Department of Pediatrics, University of Ancona, Italy.
    Source: Lancet 1994 Jan 22; Vol. 343(8891):200-3
    Comment in: Lancet 1994 Jan 22; Vol. 343(8891):188
    Comment in: Lancet 1994 Mar 12; Vol. 343(8898):675
    Comment in: Lancet 1994 Apr 16; Vol. 343(8903):984

    Celiac.com Sponsor (A12):
    Unique Identifier: 94118649 It is now generally believed that sub-clinical Coeliac disease is common in the general population. We have undertaken screening for this disorder in a school district in central Italy. Screening was divided into three levels: first, IgG and IgA antigliadin antibody (AGA) assay on capillary blood obtained by finger prick; second, AGA plus IgA anti-endomysium antibody (AEA) test and measurement of serum immunoglobulins in venous blood; and third, intestinal biopsy. 3351 students (66% of the eligible population) aged 11-15 years attended first-level screening. 71 (2%) were recalled because of AGA positivity; 18 of these satisfied second-level criteria and underwent intestinal biopsy.

    Coeliac disease was diagnosed in 11 subjects, most of whom had no serious symptoms. Selective IgA deficiency was found in 4 subjects, 1 of whom also had coeliac disease. The prevalence of sub-clinical coeliac disease in the study group was 3.28 per 1000*. Coeliac disease screening is feasible and involves only slight discomfort to the general population. Such screening can detect large numbers of cases of Coeliac disease, which can be treated with a gluten-free diet. Many sub-clinical cases of Coeliac disease would not be detected by screening only a selected group of at-risk patients.

    The following chart summarizes the study:

    No. of Students in Study No. Positive for IgG and IgA Antigliadin Antibodies No. Positive for AGA plus IgA Anti-Endomysium Antibodies No. w/ Positive Intestinal Biopsy
    3,351 ( = 100%) 71 ( = 2.1%) 18 ( = 0.537%) 11 ( =.328%)

    *Please note that the finding in this study of 3.28 per 1000 includes only those who satisfied all criteria of diagnosis, including a biopsy. Many of the original 71 kids (2%) who tested positive for IgG and IgA antigliadin antibodies may later develop typical or atypical symptoms, and have positive intestinal biopsies.


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  • About Me

    Scott Adams

    Scott Adams was diagnosed with celiac disease in 1994, and, due to the nearly total lack of information available at that time, was forced to become an expert on the disease in order to recover. In 1995 he launched the site that later became Celiac.com to help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives.  He is co-author of the book Cereal Killers, and founder and publisher of the (formerly paper) newsletter Journal of Gluten Sensitivity. In 1998 he founded The Gluten-Free Mall which he sold in 2014. Celiac.com does not sell any products, and is 100% advertiser supported.

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