Screening for coeliac disease in healthy blood donors at two immune-transfusion centres in North-East Italy

Background and aims. In the past, the reported prevalence of coeliac diseas e ranged from 1:1000 to 1:4000, whereas recent studies using serological sc reening methods have found a significantly higher prevalence. The aim of th is study was to investigate the prevalence of coeliac disease in healthy bl ood donors in a North-eastern region of Italy. Subjects. a total of 4000 healthy blood donors were studied from two immuno transfusion centres. Methods. Serum IgA-antiendomysium antibodies were detected by indirect immu nofluorescence using human umbilical cord vein sections, and positive sera were tested also on monkey oesophagus tissue. Intestinal biopsy was perform ed in all antiendomysium-positive subjects. Results. Ten out of 4000 sera screened were found to be antiendomysium posi tive on human umbilical cord vein. All positive patients had flat mucosa on intestinal biopsy. Five subjects had coeliac disease-related clinical feat ures (2 had a history of gastrointestinal symptoms, I a family history of I DDM, 1 sideropenic anaemia, and I IgA deficiency). One of the ten serum, an tiendomysium positive on human umbilical cord vein, was found to de negativ e when tested on monkey oesophagus. Conclusions. These data confirm, the high prevalence of undiagnosed silent coeliac disease in the healthy adult population. This is the first study wh ere umbilical cord was used for screening coeliac disease in a large popula tion. The human umbilical cord vein indirect immunofluorescence test is mor e specific for villous atrophy than conventional indirect immunofluorescenc e test on monkey oesophagus and is a reliable screening test for coeliac di sease in an apparently healthy population.