PERSPECTIVE
Coeliac disease
The changing face of coeliac disease
Correspondence to:
Correspondence to:
R M Beattie
Paediatric Medical Unit, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK;mark.beattie@suht.swest.nhs.uk
Perspective on the paper by Ravikumara et al (see page 969)
| The first 150 words of the full text of this article appear below. |
Coeliac disease is an autoimmune-mediated enteropathy triggered by the ingestion of gluten in genetically susceptible individuals. The major predisposing genotypes are HLA-DQ2 and HLA-DQ8 found in at least 98% of patients. The widespread use of antibody screening has considerably changed the clinical spectrum of new cases seen with increasing recognition, through the testing of children with less classic symptoms and screening of children at high risk, of the varied presentation and increased prevalence of this now common condition.
Coeliac disease was previously considered to be rare, with an estimated prevalence of 1 in 2000. This was before the widespread availability of antibody screening. The prevalence of coeliac disease, based on either cross-sectional or population-based studies in Western populations, is in the order of 0.3–2%, with a higher prevalence in at-risk groups.1–3 The vast majority of cases, however, remain undetected, with seropositivity in apparently healthy individuals when populations are
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