Spanish National Registry of Celiac Disease
Incidence and Clinical Presentation
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Collaborating members of the Spanish Working Group on Coeliac Disease: D. Acuña (Hospital Universitario Niño Jesús, Madrid); F. Argüelles (Hospital Universitario Virgen de la Macarena, Sevilla); E. Balmaseda (Complejo Hospitalario Universitario de Albacete); J.M. Bartolomé (Hospital de Palencia); A. Bodas (Hospital Clínico, Madrid); M. Carreras (Hospital Mutua de Terrassa); F. Clemente, O. Manrique (Hospital General de Alicante); P. Codoñer (Hospital Universitario Dr. Peset, Valencia); J.I. García; (Complejo Hospitalario Xeral-Cies, Vigo); R. García (Hospital Mutua de Terrassa); M. Jané (Hospital de Niños de Barcelona); H. Lorenzo (Hospital de Basurto, Bilbao); C. Maluenda (Hospital Clínico, Madrid); E. Martín Bejarano (Hospital de Basurto, Bilbao); C. Martinez (Hospital Clínico Universitario, Valencia); M. Marugan (Hospital Clínico Universitario, Valladolid); G. Mascort (Hospital Infanta Margarita, Córdoba); F. Morales (Hospital de Torrecárdenas, Almería); A. Rayo (Hospital Severo Ochoa, Madrid); A. Rodríguez (Hospital Virgen del Rocío, Sevilla); C. Sierra (Hospital Materno Infantil, Málaga); R. Solaguren (Hospital Virgen de la Salud, Toledo); E. Ubalde (Hospital San Jorge, Huesca); I. Vitoria (Hospital De Xátiva, Valencia).
The study was supported by research funds from the Spanish Society for Pediatric Gastroenterology, Hepatology and Nutrition.
The authors report no conflicts of interest.
ABSTRACT
Objectives:
The aim of this study was to assess the incidence and clinical pattern of celiac disease (CD) presently diagnosed in Spanish children.
Methods:
A prospective, multicenter, nationwide registry of new cases of CD in children <15 years was conducted from June 1, 2006 to May 31, 2007. The parameters studied were age at diagnosis, sex, clinical symptoms, associated diseases, nutritional status, CD serology, histological lesions, and HLA-DQ2/-DQ8. The crude incidence rate of CD was calculated as new cases per 1000 live births and as new cases per 100,000 person-years <15 years of age.
Results:
A total of 974 new cases of CD were included. The median age at diagnosis was 2.3 years; 39.5% of CD diagnoses occurred in the first 2 years, 42% between 2 and 6, and 18.4% from 6 to 15. Total number of cases in each age group was 385, 409, and 180, respectively. Regarding clinical presentation 70.9% showed classical symptoms, 21.9% were nonclassical, and 7% were asymptomatic. A total of 95.7% of 931, 94.7% of 611, and 86.7% of 651 children tested positive, respectively, for immunoglobulin A (IgA) anti-transglutaminase type 2 antibodies, IgA endomysial antibodies, and IgA anti-gliadin antibodies. Villous atrophy was observed in 92.4% and increased intraepithelial lymphocytes with crypt hyperplasia in 3.3%. Of the children, 55% had normal growth, and 3.4% were overweight. The HLA phenotype was DQ2: 88.3%, DQ2/DQ8: 8.4%, and DQ8: 2.3%. The incidence rate was 7.9 cases of CD per 1000 live births and 54 cases per 100,000 person-years.
Conclusions:
In Spain, the most frequent clinical presentation of CD is the classical form, mainly diagnosed during the first 2 years of life. The observed incidence of CD in Spanish children is much higher than the present CD incidence rates observed in other European countries.
