Incidence and presentation of coeliac disease in South Glamorgan

Objective To determine the incidence and presenting features of coeliac dis ease and dermatitis herpetiformis in the population of South Glamorgan betw een 1981 acid 1995. Design Retrospective case-finding study using pathology, dietetic and clini cal records, data from hospital activity analysis, general practice records and a Coeliac Society questionnaire. Incidence rates were calculated using the Registrar General's mid-year estimates. Setting Regional hospitals, South Glamorgan, Wales. Participants All new cases of coeliac disease or dermatitis herpetiformis. Main outcome measures Crude incidence rates (per quinquennia) for both chil dren and adults. Age, sex, family history, symptoms at the time of diagnosi s and time to diagnosis from symptom onset. Results In total, 137 cases of coeliac disease (27 children, 110 adults) an d 19 cases of dermatitis herpetiformis were detected. In adults with coelia c disease, incidence rates have risen from 1.32 to 3.08 per 100 000 with a 3:1 female predominance. Almost 50% of adults were over fifty years old whe n diagnosed and 25% had no abdominal symptoms. In children, the disease inc idence has remained stable but with a rising trend in mean age at diagnosis and higher likelihood of atypical symptoms in older children. There has be en no change in the incidence of dermatitis herpetiformis. Only 8.3% of all patients had an affected first-degree relative. Conclusions In contrast to other reports of declining incidence, coeliac di sease in children has remained constant in South Glamorgan, but has markedl y increased in adults, particularly women. Presentation may be at any age, often with atypical symptoms, which may delay diagnosis. fur I Gastroentero l Hepatol 12:345 - 349 (C) 2000 Lippincott Williams & Wilkins.