Undiagnosed coeliac disease at age seven: population based prospective birth cohort study

Coeliac disease is uncommon in childhood and diagnosed in fewer than 1 in 2500 children in the United Kingdom.1 Subclinical disease is, however, common in adults, and can be detected by testing for serum IgA antiendomysial antibodies (IgA-EMA).2 We aimed to establish the prevalence of undiagnosed coeliac disease in the general population at age seven, and to look for associated clinical features. We studied children aged 7.5 years participating in the Avon Longitudinal Study of Parents and Children (ALSPAC), a population based birth cohort study established in 1990.3 Two stage screening included a sensitive initial radioimmunoassay for antibodies to tissue transglutaminase (endomysial antigen) with further testing of positive samples for IgA-EMA by indirect immunofluorescence.4 Children with tTG antibodies below the 97.5th centile were defined as antibody negative. Height, weight, and haemoglobin levels were measured at dedicated study clinics. Details of gastrointestinal symptoms and special diets were collected by routine questionnaire at age 6.75 years. Of …