Celiac Disease - NIH Consensus Development Program - National ...

the risk and severity of CD may also account for geographic and temporal variation in theincidence of CF and may be of great public health importance.ProgressionWhile there is growing evidence for a remitting-relapsing pattern of CD autoimmunity insome patients, (4,11) the disease process defined by current serological and histopathologicaltechniques is remarkably persistent in the absence of gluten-free diet. A two- to threefold excessin all-cause mortality among CD patients, compared to the general population, has been reportedin some studies (12,13) and attributed to GI tract malignancies. (14,15)In summary, CD is a protean systemic disease affecting up to 1 percent of the generalpopulation. Appropriate screening, diagnosis, and treatment guidelines are being redefined usingimproved diagnostic methods that include IgA TG testing and HLA-DQB1 typing, in addition toSBB.References1. Walker-Smith J, Guandalini S, Schmitz J, Shmerling D, Visakorpi J. Revised criteria fordiagnosis of coeliac disease. Report of Working Group of European Society of PaediatricGastroenterology and Nutrition. Arch Dis Child. 1990;65:909–911.2. Catassi C, Cellier C, Cerf-Bensussan N, et al. When is a coeliac a coeliac? Report of aworking group of the United European Gastroenterology Week in Amsterdam. EuropeanJournal of Gastroenterology & Hepatology. 2001;13:1123–1128.3. Murray JA, Van Dyke C, Plevak MF, Dierkhising RA, Zinsmeister AR, Melton LJ, III.Trends in the identification and clinical features of celiac disease in a North Americancommunity, 1950–2001. Clin Gastroenterol Hepatol. 2003;1:19–27.4. Maki M, Mustalahti K, Kokkonen J, et al. Prevalence of celiac disease among children inFinland. N Engl J Med. 2003;348:2517–2524.5. Carlsson A, Axelsson I, Borulf S, et al. Prevalence of IgA-antigliadin antibodies andIgA-antiendomysium antibodies related to celiac disease in children with Down syndrome.Pediatrics. 1998;101:272–275.6. Catassi C, Ratsch IM, Fabiani E, et al. High prevalence of undiagnosed coeliac disease in5280 Italian students screened by antigliadin antibodies. Acta Paediatr. 1995;84:672–676.7. Fasano A, Berti I, Gerarduzzi T, et al. Prevalence of celiac disease in at-risk and not-at-riskgroups in the United States: A large multicenter study. Arch Intern Med. 2003;163:286–292.8. Cavell B, Stenhammar L, Ascher H, et al. Increasing incidence of childhood coeliac diseasein Sweden. Results of a national study. Acta Paediatr. 1992;81:589–592.46