Coeliac disease is an immune‐mediated enteropathy, triggered in genetically susceptible people by dietary gluten.1 Diagnosis has historically been based on positive serological test results (such as elevated anti‐tissue transglutaminase [tTG] or endomysial antibody levels) together with characteristic histological features identified by small bowel biopsy in people with typical symptoms. However, serological diagnosis (without small bowel biopsy) may be considered in children.2 In Australia, an estimated 1.2% of men and 1.9% of women have coeliac disease,3 while an electoral roll‐based study determined a rate of 1.2% in Christchurch, New Zealand.4 Both figures are consistent with the estimated pooled global prevalence of 1.4%.5
- 1. Lebwohl B, Sanders DS, Green PHR. Coeliac disease. Lancet 2018; 391: 70‐81.
- 2. Husby S, Koletzko S, Korponay‐Szabó I, et al. European Society Paediatric Gastroenterology, Hepatology and Nutrition guidelines for diagnosing coeliac disease 2020. J Pediatr Gastroenterol Nutr 2020; 70: 141‐156.
- 3. Anderson RP, Henry MJ, Taylor R, et al. A novel serogenetic approach determines the community prevalence of celiac disease and informs improved diagnostic pathways. BMC Med 2013; 11: 188.
- 4. Cook HB, Burt MJ, Collett JA, et al. Adult coeliac disease: prevalence and clinical significance. J Gastroenterol Hepatol 2000; 15: 1032‐1036.
- 5. Singh P, Arora A, Strand TA, et al. Global prevalence of celiac disease: systematic review and meta‐analysis. Clin Gastroenterol Hepatol 2018; 16: 823‐836.
- 6. Singh P, Singh AD, Ahuja V, Makharia GK. Who to screen and how to screen for celiac disease. World J Gastroenterol 2022; 28: 4493‐4507.
- 7. Singh P, Arora S, Lal S, et al. Risk of celiac disease in the first‐ and second‐degree relatives of patients with celiac disease: a systematic review and meta‐analysis. Am J Gastroenterol 2015; 110: 1539‐1548.
- 8. Sahin Y, Mermer S. Frequency of celiac disease and distribution of HLA‐DQ2/DQ8 haplotypes among siblings of children with celiac disease. World J Clin Pediatr 2022; 11: 351‐359.
- 9. Muir R, Sehgal A, Tye‐Din J, Daveson, AJM, et al. Undiagnosed coeliac disease identified by active case finding in first degree relatives of people with coeliac disease in Australia: a prospective observational study. Med J Aust 2023; 219: 371‐373.
- 10. Paavola S, Kurppa K, Huhtala H, et al. Coeliac disease re‐screening among once seronegative at‐risk relatives: a long‐term follow‐up study. United European Gastroenterol J 2022; 10: 585‐593.
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