A prospective study of the incidence of childhood celiac disease☆
Section snippets
Study Population
From December 1993 to September 1999, 22,346 newborns in Denver, Colorado underwent cord blood screening for HLA genotypes associated with CD and type 1 diabetes.13 Of all eligible children born at the St Joseph's Hospital in Denver, Colorado, 85% of parents provided informed consent for HLA screening. The newborn population of this hospital was chosen because it was representative of the general population of the Denver metropolitan area and included children classified by their mothers as
Results
Between December 1993 and September 1999, we determined the HLA-DR genotypes of 22,346 newborns. Parents of 1234 of these newborns were invited and agreed to participate in the prospective follow-up. Of these, 987 infants from 923 families have completed at least one year and 386 (40%) completed at least five years of the follow-up. TG autoantibody results for a representative participant are shown in Figure 1. Overall, 40 children have tested positive for TG autoantibody on at least one
Discussion
This study estimates that at 5 years of age, about 1% of Denver-area children have evidence of CD. This is an estimate of the minimal frequency of CD during childhood because more children may develop autoantibodies during continued follow-up and some TG autoantibody-positive children may undergo repeat small intestine biopsy demonstrating a change from normal to histologic features consistent with CD. In addition, our study design of monitoring the group expressing HLA-DR3 may miss those
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Supported by NIH grants DK R01-DK50979, DK 32493, DK32083, M01RR00069, General Clinical Research Centers Program, National Center for Research Resources, Autoimmunity Center of Excellence Grant U19AI46374, Diabetes Endocrine Research Center P3057516. None of the authors have any potential, perceived, or real conflict of interest, especially any financial arrangements with a company mentioned in this manuscript.