Celiac Disease: More Common Than Once Thought

Ellen Whipple Guthrie, PharmD; Meghan Amy Gettis, PharmD

Disclosures

US Pharmacist. 2008;33(12):24-29. 

In This Article

Epidemiology

Celiac disease previously was thought to be extremely rare in the U.S.[2,5,6,9] Two epidemiologic studies published prior to 2000 estimated that between one and 4,800 and one in 10,000 people in the U.S. were affected by celiac disease.[2,6,15,16] Population studies published in recent years, however, suggest a much higher prevalence, particularly in individuals of European ancestry.[2,4,6] One of the largest studies in the U.S. involved 13,145 participants (4,508 first-degree relatives of patients with celiac disease, 1,275 second-degree relatives, 3,236 symptomatic patients, and 4,126 not-at-risk subjects) who underwent screening.[2,6,9,12,17] The prevalence of celiac disease was 1:22 in first-degree relatives, 1:39 in second-degree relatives, 1:56 in symptomatic patients, and 1:133 in not-at-risk subjects.[2,6,9,12,17]

The likelihood of having celiac disease increases to 10% to 20% in persons who have a first-degree relative with the disease, and up to 75% in monozygotic twins.[2,3] In addition, patients who have type 1 diabetes mellitus, Down's syndrome, Turner's syndrome, or other disorders are at increased risk for developing celiac disease (Table 1).[2,3,4,7,17]

Celiac disease also occurs in people not of European descent, although the prevalence is not as great. People from the Punjab and Gujarat regions of India who lived in England developed celiac disease 2.7 times as often as Europeans on a gluten-rich diet; in addition, a disorder termed summer diarrhea has long plagued people of the tropics, especially during the summer months, when wheat commonly replaces maize in the diet.[4,12] Furthermore, a very high prevalence rate of 5% has been documented in the Saharawi population of northern Africa.[4]

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