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What Can We Learn from Decades of Celiac Disease in Rural England?

What can we learn about the epidemiology of celiac disease in a single centre in rural England?


Photo: CC--Micolo J.

Celiac.com 06/29/2017 - A team of researchers recently set out to document trends in diagnosis of celiac disease among patients from a single centre from 1958–2014, and and to provide data on rates and numbers of cases in those born in Derby city over 4 decades. The team also sought to explore a possible connection between deprivation and prevalence and characteristics of celiac disease in Asians.

The research team included Geoffrey K T Holmes, and A Muirhead. They are affiliated with the Royal Derby Hospital, Derby, UK, and the Department of Public Health, Derby City Council, Derby, UK.

The team used National Census information to identify 2,410 adult celiac patients diagnosed in Derby area hospitals. To measure changes in disease rates and individual cases over the study period, the team identified 1,077 patients born within Derby city; 191 of whom were Asian.

From 2010–2014, 20 times more patients were diagnosed than during 1975–1979. More than one-quarter of patients (27%) were diagnosed at or above 60 years of age.

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The team noted a low number of diagnoses in young men. They noted also that most women were diagnosed 35 and 45 years of age, which is 15 years earlier than men. Young women and elderly patients saw the largest increase in diagnosis rates.

In 2014, overall prevalence was 1:188. Prevalence in women was 1:138. Nearly 5 percent of the variation was attributed to deprivation. Diagnosis rates in Asians increased markedly, although only 5 percent were diagnosed at 60 years or older, far lower than for whites.

The research team calls for more research into the dramatic increase in celiac cases, and the challenges this increase presents for follow-up and new models of care need.

They encourage healthcare workers to be alert to the possibility of undiagnosed celiac disease in young men and elderly Asians. They note that a dedicated celiac clinic is helpful for increasing rates of celiac diagnosis.

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