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Celiac.com 09/16/2013 - Until recently, researchers thought celiac disease was mainly a problem in Northern Europe and Australasia, and uncommon in North America and the Middle East. However, with better data, researchers now regard celiac disease to be equally common in all these places. Celiac disease is still generally seen as rare in Asia and Sub-Saharan Africa, but a team of researchers wanted to get a better idea of geographical differences and time trends in the frequency of celiac disease. The research team included J. Y. Kang, A. H. Y. Kang, A. Green, K. A. Gwee, and K.Y. Ho. They are affiliated with the Department of Gastroenterology, St George's Hospital, London, UK, the Yong Loo Lin School of Medicine at the National University of Singapore, and with the Department of Gastroenterology and Hepatology at the National University Health System in Singapore. To get the data that would help them to compare geographical differences and time trends, the team conducted Medline and Embase searches covering a period from 1946 to 1980, using the key words: coeliac disease or celiac disease + prevalence, incidence or frequency. Their data showed significant differences between and within countries in the prevalence and incidence of celiac disease. For example, in all of reported English medical literature, there have been only 24 ethnic Chinese and Japanese patients with celiac disease. Of celiac-associated HLA DQ antigens, DQ2 occurs in 5–10% of Chinese and sub-Saharan Africans, compared to 5–20% in Western Europe. DQ8 occurs in 5–10% of English, Tunisians and Iranians, but in less than 5% of Eastern Europeans, Americans and Asians. Rates and overall numbers of both clinically and serologically diagnosed celiac disease have risen in recent years. Celiac disease is increasing in frequency, with significant geographical differences. The team's geographical and temporal differences seem genuine, but a large number of hypothesis and lack of diagnostic facilities have made it difficult to reach any solid conclusions. Although few cases have been found in Asia and Sub-Saharan Africa, there is a significant prevalence of HLA DQ2 and wheat consumption is about the same as in Western Europe. It is possible that celiac disease may become more common in these countries in the future. Source: Aliment Pharmacol Ther. 2013;38(3):226-245.

Celiac.com 01/29/2010 - A team of researchers recently set out to compare levels of glutamic acid decarboxylase antibody (anti-GAD), islet cell antibody (ICA), thyroperoxidase antibody (anti-TPO), thyroglobulin antibody (anti-TG), antinuclear antibodies (FANA), antibodies to double-stranded DNA (anti-ds DNA), antibody to Sjögren syndrome A antigen (anti-SSA), antibody to Sjögren syndrome B antigen (anti-SSB), Smith antibody (anti-Sm), smooth muscle antibodies (ASMA), and antimitochondrial antibody liver-kidney microsome (AMA-LKM) in patients with celiac disease against healthy control subjects, and autoimmune hypothyroid patients. The research team included Erkan Caglar, Serdal Ugurlu, Aliye Ozenoglu, Gunay Can, Pinar Kadioglu, and Ahmet Dobrucali. They are affiliated variously with Fatih Sultan Mehmet Education and Research Hospital, the Cerrahpasa Medical Faculty at the University of Istanbul, and Ondokuz Mayis University in Samsun, Turkey. They studied a total of 31 patients with celiac disease, 34 patients with autoimmune hypothyroidism and 29 healthy subjects. The team used immunofluorescence to assess anti-SSA, anti-SSB, anti-Sm, anti-ds DNA, anti-GAD, anti-TPO and anti-TG were studied by Enzyme-Linked Immunosorbent Assay (ELISA), and AMA-LKM, ASMA, ANA and ICA. Researchers used retrospective analysis to assess clinical data and the results of free thyroxine-thyroid stimulating hormone (FT4-TSH). The team used SPSS ver 13.0 for data analysis, and the χ2 method for comparisons within groups. They found that the frequency of anti-SSA, anti-SSB, anti-GAD, anti-Sm, anti-ds DNA, AMA-LKM, ASMA, ANA and ICA did not differ significantly between the groups. They found levels of anti-TPO and anti-TG antibodies to be markedly higher (<0.001) in autoimmune hypothyroid patients as compared with other groups. Previous studies have shown an increased frequency of autoimmune diseases of other systems in people with celiac disease. Autoimmune antibodies specific for other autoimmune diseases appeared no more frequent in people with celiac disease. Source: U.S. National Library of Medicine, National Institutes of Health

Celiac.com 05/08/2007 - A recent study published in the journal Digestive Diseases and Sciences indicates that lesser degrees of villous atrophy correspond to seronegative celiac disease. The study was conducted by researchers J.A. Abrams, B. Diamond, H. Rotterdam, and P.H. Green, of the Department of Medicine, Columbia University College of Physicians and Surgeons in New York City. The research team set out to assess the effectiveness of various serologic tests used to diagnose celiac disease in patients with differing degrees of villous atrophy. The team evaluated 115 adult patients with biopsy-proven celiac disease. All participants met strict criteria, including serologic testing at the time of diagnosis and response to a gluten-free diet, 71% of participants showed total villous atrophy and 29% showed partial villous atrophy. Of those with total villous atrophy, 77% tested positive for endomysial antibody, compared to 33% with partial villous atrophy (P < 0.001). No difference in sensitivity was found between those who classical presentation of celiac disease versus those with silent presentation. Also, patients who were endomysial positive and patients who were endomysial negative showed no difference with respect to age at diagnosis, duration of symptoms, mode of presentation, or family history of celiac disease. Endomysial antibody positivity correlated not with the mode of presentation of celiac disease, but rather, with more severe villous atrophy. Lastly, the study showed that, in clinical practice, serologic tests lack the sensitivity reported in the literature. Digestive Diseases and Sciences, 2004 Apr; 49(4):546-50. health writer who lives in San Francisco and is a frequent author of articles for Celiac.com.