CELIAC-DISEASE - INCIDENCE AND PREVALENCE IN WELLINGTON 1985-92

Aim. A retrospective study was carried out in the greater Wellington a rea. The objectives of this study were to identify an incidence rate, presenting symptoms and clinical features of coeliac disease. Methods. Histology archives from the Wellington hospital department of patholo gy over the last eight years (1985-92) were retrieved and analysed. Ab normal duodenal and jejunal histological sections were reviewed. One h undred and seventy seven biopsy specimens from 127 patients were ident ified for further study from a total of 367 abnormal duodenal and jeju nal biopsy specimens. Diagnosis of coeliac disease was based on inform ation from hospital notes, biopsy request forms, and histology reports . Diagnostic criteria used for coeliac disease were evidence of malabs orption, abnormal histology consistent with coeliac disease and clinic al improvement following a gluten free diet. Results. Thirty eight pat ients were diagnosed with coeliac disease 1985-92 in a population of 2 67 252. Of these 38 only four were children (0-12 years). Overall inci dence was 1.8 per 100 000. The estimated overall prevalence was 70 per 100 000, with 14 per 100 000 for children. The live birth rate was 0. 1 per 1000. There was a female predominance of 3:1. Patients presented with a diverse range of problems, most commonly diarrhoea, anaemia, w eight loss and steatorrhoea. Three out of the 6 patients who had a sin gle problem had anaemia. Conclusions. The study has demonstrated an ov erall incidence and prevalence of coeliac disease in the Wellington re gion similar to overseas figures.1,2 However only 11% of the total wer e children, which is a very low proportion compared to the 50% reporte d in Sweden2 and 25% in Edinburgh.4 Patients presented with a wide ran ge of clinical features. The threshold for small bowel biopsy should b e relatively low in any patient considered to have clinical features o f malabsorption