The coeliac iceberg in Italy. A multicentre antigliadin antibodies screening for coeliac disease in school-age subjects

C. Catassi, E. Fabiani, I. M. Rätsch, G. V. Coppa, P. L. Giorgi, R. Pierdomenico, S. Alessandrini, G. Iwanejko, R. Domenici, E. Mei, A. Miano, M. Marani, G. Bottaro, M. Spina, M. Dotti, A. Montanelli, M. Barbato, F. Viola, R. Lazzari, M. Vallini & 15 others G. Guariso, M. Plebani, F. Cataldo, G. Traverse, C. Ughi, G. Chiaravalloti, M. Baldassarre, P. Scarcella, F. Bascietto, L. Ceglie, A. Valenti, P. Paolucci, M. Caradonna, E. Bravi, A. Ventura

Research output: Contribution to journalArticle

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Abstract

Background: Recent studies suggest that coeliac disease (CD) is one of the commonest, life-long disorders in Italy. The aims of this multicentre work were: (a) to establish the prevalence of CD on a nationwide basis; and (b) to characterize the CD clinical spectrum in Italy. Patients and methods: Fifteen centres screened 17201 students aged 6-15 years (68.6% of the eligible population) by the combined determination of serum IgG- and IgA-antigliadin antibody (AGA) test; 1289 (7.5%) were IgG and/or IgA-AGA positive and were recalled for the second-level investigation; 111 of them met the criteria for the intestinal biopsy: IgA-AGA positivity and/or AEA positivity or IgG-AGA positivity plus serum IgA deficiency. Results: Intestinal biopsy was performed on 98 of the 111 subjects. CD was diagnosed in 82 subjects (75 biopsy proven, 7 not biopsied but with associated AGA and AEA positivity). Most of the screening-detected coeliac patients showed low-grade intensity illness often associated with decreased psychophysical well-being. There were two AEA negative cases with associated CD and IgA deficiency. The prevalence of undiagnosed CD was 4.77 x 1000 (95% CI 3.79-5.91), 1 in 210 subjects. The overall prevalence of CD, including known CD cases, was 5.44 x 1000 (95% CI 4.57-6.44), 1 in 184 subjects. The ratio of known to undiagnosed CD cases was 1 in 7. Conclusions: These findings confirm that, in Italy, CD is one of the most common chronic disorders showing a wide and heterogeneous clinical spectrum. Most CD cases remain undiagnosed unless actively searched.

LanguageEnglish
Pages29-35
Number of pages7
JournalActa Paediatrica, International Journal of Paediatrics, Supplement
Volume85
Issue number412
Publication statusPublished - 1996

Fingerprint

Ice Cover
Celiac Disease
Abdomen
Italy
Antibodies
Immunoglobulin A
IgA Deficiency
Immunoglobulin G
Biopsy
Serum

Keywords

  • antiendomysium antibodies
  • Antigliadin antibodies
  • coeliac disease
  • epidemiology
  • screening

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Catassi, C., Fabiani, E., Rätsch, I. M., Coppa, G. V., Giorgi, P. L., Pierdomenico, R., ... Ventura, A. (1996). The coeliac iceberg in Italy. A multicentre antigliadin antibodies screening for coeliac disease in school-age subjects. Acta Paediatrica, International Journal of Paediatrics, Supplement, 85(412), 29-35.

The coeliac iceberg in Italy. A multicentre antigliadin antibodies screening for coeliac disease in school-age subjects. / Catassi, C.; Fabiani, E.; Rätsch, I. M.; Coppa, G. V.; Giorgi, P. L.; Pierdomenico, R.; Alessandrini, S.; Iwanejko, G.; Domenici, R.; Mei, E.; Miano, A.; Marani, M.; Bottaro, G.; Spina, M.; Dotti, M.; Montanelli, A.; Barbato, M.; Viola, F.; Lazzari, R.; Vallini, M.; Guariso, G.; Plebani, M.; Cataldo, F.; Traverse, G.; Ughi, C.; Chiaravalloti, G.; Baldassarre, M.; Scarcella, P.; Bascietto, F.; Ceglie, L.; Valenti, A.; Paolucci, P.; Caradonna, M.; Bravi, E.; Ventura, A.

In: Acta Paediatrica, International Journal of Paediatrics, Supplement, Vol. 85, No. 412, 1996, p. 29-35.

Research output: Contribution to journalArticle

Catassi, C, Fabiani, E, Rätsch, IM, Coppa, GV, Giorgi, PL, Pierdomenico, R, Alessandrini, S, Iwanejko, G, Domenici, R, Mei, E, Miano, A, Marani, M, Bottaro, G, Spina, M, Dotti, M, Montanelli, A, Barbato, M, Viola, F, Lazzari, R, Vallini, M, Guariso, G, Plebani, M, Cataldo, F, Traverse, G, Ughi, C, Chiaravalloti, G, Baldassarre, M, Scarcella, P, Bascietto, F, Ceglie, L, Valenti, A, Paolucci, P, Caradonna, M, Bravi, E & Ventura, A 1996, 'The coeliac iceberg in Italy. A multicentre antigliadin antibodies screening for coeliac disease in school-age subjects' Acta Paediatrica, International Journal of Paediatrics, Supplement, vol. 85, no. 412, pp. 29-35.
Catassi, C. ; Fabiani, E. ; Rätsch, I. M. ; Coppa, G. V. ; Giorgi, P. L. ; Pierdomenico, R. ; Alessandrini, S. ; Iwanejko, G. ; Domenici, R. ; Mei, E. ; Miano, A. ; Marani, M. ; Bottaro, G. ; Spina, M. ; Dotti, M. ; Montanelli, A. ; Barbato, M. ; Viola, F. ; Lazzari, R. ; Vallini, M. ; Guariso, G. ; Plebani, M. ; Cataldo, F. ; Traverse, G. ; Ughi, C. ; Chiaravalloti, G. ; Baldassarre, M. ; Scarcella, P. ; Bascietto, F. ; Ceglie, L. ; Valenti, A. ; Paolucci, P. ; Caradonna, M. ; Bravi, E. ; Ventura, A. / The coeliac iceberg in Italy. A multicentre antigliadin antibodies screening for coeliac disease in school-age subjects. In: Acta Paediatrica, International Journal of Paediatrics, Supplement. 1996 ; Vol. 85, No. 412. pp. 29-35.
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title = "The coeliac iceberg in Italy. A multicentre antigliadin antibodies screening for coeliac disease in school-age subjects",
abstract = "Background: Recent studies suggest that coeliac disease (CD) is one of the commonest, life-long disorders in Italy. The aims of this multicentre work were: (a) to establish the prevalence of CD on a nationwide basis; and (b) to characterize the CD clinical spectrum in Italy. Patients and methods: Fifteen centres screened 17201 students aged 6-15 years (68.6{\%} of the eligible population) by the combined determination of serum IgG- and IgA-antigliadin antibody (AGA) test; 1289 (7.5{\%}) were IgG and/or IgA-AGA positive and were recalled for the second-level investigation; 111 of them met the criteria for the intestinal biopsy: IgA-AGA positivity and/or AEA positivity or IgG-AGA positivity plus serum IgA deficiency. Results: Intestinal biopsy was performed on 98 of the 111 subjects. CD was diagnosed in 82 subjects (75 biopsy proven, 7 not biopsied but with associated AGA and AEA positivity). Most of the screening-detected coeliac patients showed low-grade intensity illness often associated with decreased psychophysical well-being. There were two AEA negative cases with associated CD and IgA deficiency. The prevalence of undiagnosed CD was 4.77 x 1000 (95{\%} CI 3.79-5.91), 1 in 210 subjects. The overall prevalence of CD, including known CD cases, was 5.44 x 1000 (95{\%} CI 4.57-6.44), 1 in 184 subjects. The ratio of known to undiagnosed CD cases was 1 in 7. Conclusions: These findings confirm that, in Italy, CD is one of the most common chronic disorders showing a wide and heterogeneous clinical spectrum. Most CD cases remain undiagnosed unless actively searched.",
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author = "C. Catassi and E. Fabiani and R{\"a}tsch, {I. M.} and Coppa, {G. V.} and Giorgi, {P. L.} and R. Pierdomenico and S. Alessandrini and G. Iwanejko and R. Domenici and E. Mei and A. Miano and M. Marani and G. Bottaro and M. Spina and M. Dotti and A. Montanelli and M. Barbato and F. Viola and R. Lazzari and M. Vallini and G. Guariso and M. Plebani and F. Cataldo and G. Traverse and C. Ughi and G. Chiaravalloti and M. Baldassarre and P. Scarcella and F. Bascietto and L. Ceglie and A. Valenti and P. Paolucci and M. Caradonna and E. Bravi and A. Ventura",
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T1 - The coeliac iceberg in Italy. A multicentre antigliadin antibodies screening for coeliac disease in school-age subjects

AU - Catassi, C.

AU - Fabiani, E.

AU - Rätsch, I. M.

AU - Coppa, G. V.

AU - Giorgi, P. L.

AU - Pierdomenico, R.

AU - Alessandrini, S.

AU - Iwanejko, G.

AU - Domenici, R.

AU - Mei, E.

AU - Miano, A.

AU - Marani, M.

AU - Bottaro, G.

AU - Spina, M.

AU - Dotti, M.

AU - Montanelli, A.

AU - Barbato, M.

AU - Viola, F.

AU - Lazzari, R.

AU - Vallini, M.

AU - Guariso, G.

AU - Plebani, M.

AU - Cataldo, F.

AU - Traverse, G.

AU - Ughi, C.

AU - Chiaravalloti, G.

AU - Baldassarre, M.

AU - Scarcella, P.

AU - Bascietto, F.

AU - Ceglie, L.

AU - Valenti, A.

AU - Paolucci, P.

AU - Caradonna, M.

AU - Bravi, E.

AU - Ventura, A.

PY - 1996

Y1 - 1996

N2 - Background: Recent studies suggest that coeliac disease (CD) is one of the commonest, life-long disorders in Italy. The aims of this multicentre work were: (a) to establish the prevalence of CD on a nationwide basis; and (b) to characterize the CD clinical spectrum in Italy. Patients and methods: Fifteen centres screened 17201 students aged 6-15 years (68.6% of the eligible population) by the combined determination of serum IgG- and IgA-antigliadin antibody (AGA) test; 1289 (7.5%) were IgG and/or IgA-AGA positive and were recalled for the second-level investigation; 111 of them met the criteria for the intestinal biopsy: IgA-AGA positivity and/or AEA positivity or IgG-AGA positivity plus serum IgA deficiency. Results: Intestinal biopsy was performed on 98 of the 111 subjects. CD was diagnosed in 82 subjects (75 biopsy proven, 7 not biopsied but with associated AGA and AEA positivity). Most of the screening-detected coeliac patients showed low-grade intensity illness often associated with decreased psychophysical well-being. There were two AEA negative cases with associated CD and IgA deficiency. The prevalence of undiagnosed CD was 4.77 x 1000 (95% CI 3.79-5.91), 1 in 210 subjects. The overall prevalence of CD, including known CD cases, was 5.44 x 1000 (95% CI 4.57-6.44), 1 in 184 subjects. The ratio of known to undiagnosed CD cases was 1 in 7. Conclusions: These findings confirm that, in Italy, CD is one of the most common chronic disorders showing a wide and heterogeneous clinical spectrum. Most CD cases remain undiagnosed unless actively searched.

AB - Background: Recent studies suggest that coeliac disease (CD) is one of the commonest, life-long disorders in Italy. The aims of this multicentre work were: (a) to establish the prevalence of CD on a nationwide basis; and (b) to characterize the CD clinical spectrum in Italy. Patients and methods: Fifteen centres screened 17201 students aged 6-15 years (68.6% of the eligible population) by the combined determination of serum IgG- and IgA-antigliadin antibody (AGA) test; 1289 (7.5%) were IgG and/or IgA-AGA positive and were recalled for the second-level investigation; 111 of them met the criteria for the intestinal biopsy: IgA-AGA positivity and/or AEA positivity or IgG-AGA positivity plus serum IgA deficiency. Results: Intestinal biopsy was performed on 98 of the 111 subjects. CD was diagnosed in 82 subjects (75 biopsy proven, 7 not biopsied but with associated AGA and AEA positivity). Most of the screening-detected coeliac patients showed low-grade intensity illness often associated with decreased psychophysical well-being. There were two AEA negative cases with associated CD and IgA deficiency. The prevalence of undiagnosed CD was 4.77 x 1000 (95% CI 3.79-5.91), 1 in 210 subjects. The overall prevalence of CD, including known CD cases, was 5.44 x 1000 (95% CI 4.57-6.44), 1 in 184 subjects. The ratio of known to undiagnosed CD cases was 1 in 7. Conclusions: These findings confirm that, in Italy, CD is one of the most common chronic disorders showing a wide and heterogeneous clinical spectrum. Most CD cases remain undiagnosed unless actively searched.

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KW - Antigliadin antibodies

KW - coeliac disease

KW - epidemiology

KW - screening

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