Prevalence of silent coeliac disease in atopics

Background. Coeliac disease sometimes runs a subclinical/silent course and is often associated with immunologic and non-immunologic diseases. Although atopy is described as one of the most frequently associated conditions, th e prevalence of coeliac disease in atopics has not yet been established. Aim, To evaluate the frequency of coeliac disease in an Italian series of a topics. Patients and Methods. Sera from 401 consecutive atopics with no clinical ev idence of malabsorption were tested for IgA antiendomysial antibodies by in direct immunofluorescence on human umbilical cord and IgA anti tissue trans glutaminase by enzyme-linked immunosorbent assay. Results. Four patients (1%) were found to be positive for both autoantibodi es. Intestinal biopsy confirmed the diagnosis of active coeliac disease. On e of the 4 coeliacs was also affected by Down's syndrome, autoimmune thyroi ditis and coeliac hepatitis. In another case, a previously unknown severe i ron deficiency was detected. Conclusions. The present study shows, for the first time, that the prevalen ce of coeliac disease in atopics is 1%, which is significantly higher than that in the general Italian population. Therefore, atopy should be consider ed a condition at risk and atopic patients routinely screened by means of s pecific autoantibody testing.