In the new study researchers at the University of Calgary and Alberta Children's Hospital in Canada found that the rate of coeliac disease diagnoses at their hospital tripled after the introduction, in 1997, of antibody testing.
Although the study covered only a single centre other research has similarly found increases in celiac diagnoses after the introduction of antibody testing.
The research looked at 266 children who were referred to the hospital between 1990 and 2006 for an intestinal biopsy and ultimately diagnosed with celiac disease.
Between 1990 and 1996 – before antibody tests were available – 36 children were diagnosed, 67% of whom had been referred for testing because of ‘classic’ symptoms. The children were typically about 2 years old when diagnosed.
However, between 2000 and 2006, 199 children were diagnosed, with the typical age at diagnosis increasing to age 9. Only 19% of these children had classic celiac symptoms. Instead, 38% had atypical digestive symptoms, like chronic abdominal pain, while 15% had non-digestive symptoms, such as iron deficiency and poor growth.
The rest of the children – 28% – had shown no clear symptoms, but were referred for testing because they had a family history of coeliac disease or had medical conditions associated with a higher risk of the disorder, including type 1 diabetes and Down's syndrome.
Dr J Decker Butzner, who led the research, suggested that blood testing for celiac disease should be performed when a child has chronic gastrointestinal symptoms of any kind that do not improve on their own or respond to treatment but stressed that the antibody blood tests are only a screening procedure and do not provide a definitive diagnosis. A positive test result needs to be followed up by an intestinal biopsy.
Pediatrics, December 2009.
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