THE SMALLER SIZE OF THE CELIAC ICEBERG IN ADULTS

Background: Since it has been ascertained that the prevalence of coeli ac disease in the general paediatric population is 3.3 per 1000, we de cided to evaluate this prevalence in the general adult population. Met hods: Two thousand two hundred and thirty-seven adult subjects aged 20 -87 years, representative of a population with sociodemographic charac teristics typical of Western European countries with regard to sex and age, were studied. In all serum IgA antiendomysial antibodies (EMA) w ere searched for, and all patients who turned out to be positive under went intestinal biopsy. Results: Four symptomless subjects aged betwee n 20 and 39 years proved positive at the IgA EMA screening. The intest inal biopsy confirmed coeliac disease in all of them. The prevalence i n our study group was, therefore, 1.8 per 1000. Conclusions: This stud y shows that the size of the submerged part of the 'coeliac iceberg' i s perhaps smaller in the adult population and suggests a linear trend towards a lower coeliac disease prevalence as age increases.