Incidence of symptomatic childhood celiac disease in France

OBJECTIVE: The study was carried out by the GFHGNP to determine the annual incidence of symptomatic celiac disease in children. PATIENTS AND METHODS: The diagnostic criteria were: symptomatic patients di agnosed under 15 years of age during 1996, villous atrophy and positivity o f antigliadin and/or other antibodies. Cases were collected from referral c enters, general hospital pediatric departments and private pediatricians wi th endoscopic practice. RESULTS: The study involved roughly half of the French pediatric population in 41 out of the 95 French districts. In all, 124 patients were collected: 76 girls and 48 boys. By geographical areas, in 30 districts where collect ion of data was complete which counted 186 285 births, the yearly incidence varied from 1/1731 births to 1/3110. (0.57% to 0.32%). On the whole there were 77 cases i.e. an annual incidence of 1/2419 or 0.41% (confidence inter val 95% : 0.32 to 0.50%). Lower incidences were observed in the district of Paris: 1/4865 (0.21%) and Lyon : 1/3310 (0.27%). Those lower incidences co uld be explained by the difficulties of collecting the data in the biggest urban areas. The first signs occurred before one year of age in 73% of the cases, during the second year of life in 20.5% and after 3 in only 6.5%. Th e diagnosis was made before 2 years of age in 77% of the cases and after 3 in only 13%. In order of frequency symptoms were: failure to thrive (80%), diarrhea (59%), anorexia (59%), abdominal distension (57%), weight under 2 standard deviations (43%), short stature (43%). CONCLUSION: Compared with previous studies in two French districts between 1975 and 1990, the annual incidence of symptomatic celiac disease in childr en appears to be on the rise. The usual clinical signs continue to be obser ved.