DOWNS-SYNDROME IS STRONGLY ASSOCIATED WITH CELIAC-DISEASE

Background-There is evidence of an increased prevalence of coeliac dis ease in Down's syndrome. Aims-To investigate the association, patients with Down's syndrome and matched controls were examined. Methods-Fift y nine patients with Down's syndrome residing in government institutio ns in the Hunter region of New South Wales were studied. Four were exc luded (terminally ill=1, uncooperative=3). Each of 55 patients was mat ched for age, sex, and residence with a control patient. Patients with both positive IgA and IgG antigliadin antibodies were considered for endoscopical duodenal biopsy. Results-Twenty one patients and two cont rols had raised IgA and IgG antibodies (chi(2)=19.4; p<0.001). Tissue was obtained in 18 patients. Two had characteristic flat, five pronoun ced lymphocytic infiltration not diagnostic of coeliac disease, two gi ardiasis, and eight were normal. In one the tissue was not suitable fo r analysis. There were few differences between the subgroups in their anthropomorphic, biochemical, or haematological findings. Conclusions- The prevalence of coeliac disease in these 51 patients with Down's syn drome is at least two (3.9%; 95% confidence interval (95% CI) 0%-9.2%) and could be as many as seven (13.7%; 95% CI 4.3%-23.2%). In this com munity the prevalence of coeliac disease in Down's syndrome is increas ed more than 100-fold (x 135-473).