Prevalence of celiac disease among blood donors in Brazil

OBJECTIVE: There are no studies on the prevalence of celiac disease (CD) in either Brazil or, as far as we know, South America. The aim of this study was to determine the prevalence of CD in healthy blood donors in the city o f Brasilia, Brazil. METHODS: Sera were obtained, independently of age and gender, from an unsel ected group of 2045 blood donors attending the Hematological Center of Bras ilia. An IgG antigliadin antibody (AGA) test was used as a first-level scre ening step, followed by IgA-AGA test, serum IgA antiendomysium (EMA), and t otal serum IgA determination performed in all sera showing abnormally high IgG-AGA results. Jejunal biopsy was suggested for all subjects showing at l east one of the following: IgA-EMA positivity; IgG-AGA and IgA-AGA positivi ty; IgG-AGA positivity and selective IgA deficiency. AGA was determined by an enzyme-linked immunosorbent assay (ELISA) technique and IgA-EMA was asce rtained by indirect immunofluorescence on cryostat sections of monkey esoph agus. Jejunal mucosa samples were obtained with a Watson capsule. RESULTS: Sixty-two (3.03%) blood donors had IgG-AGA above the cut-off value s. Fifty-eight individuals showed isolated high values of IgG-AGA, whereas four had simultaneously increased IgG and IgA-AGA. Three patients had posit ive IgA-EMA test (one with both IgG- and IgA-AGA and two with only IgG-AGA) and underwent jejunal biopsies that disclosed complete villous atrophy ass ociated with an increased number of intraepithelial lymphocytes and hypertr ophic criptae. In this study group, the prevalence of biopsy-proven celiac disease was 1.47 +/- 1.66 in 1000 subjects. CONCLUSIONS: We found a prevalence of undiagnosed CD of 1:681 among apparen tly healthy blood donors. These preliminary results support the view that C D is not a rare disease in Brazil. (Am J Gastroenterol 2000;95:689-692. (C) 2000 by Am. Cell. of Gastroenterology).