Almallouhi E, et al. - This trial entailed the exploration of the incidence and altered presentation of childhood celiac disease (CD) in a well-defined cohort. A persistent rise was noted in both the incidence and prevalence of CD, in children during the past 15 years in Olmsted County, Minnesota. Clinical and pathologic presentations of CD appeared to vary over time (more nonclassical and asymptomatic cases were emerging).

Methods

• A retrospective appraisal was performed of the Mayo Clinic and Olmsted Medical Center medical records from January 1994 to December 2014, with the aid of the Rochester Epidemiology Project.
• All CD cases of patients aged 18 years or younger were detected, at the time of diagnosis.
• An estimation was conducted of the incidence rates by adjusting for age, sex, and calendar year and standardizing to the 2010 US white population.

Results

• 100 patients with CD were selected.
• An increase was reported in the incidence of CD from 8.1 per 100,000 person-years (2000-2002) to 21.5 per 100,000 person-years (2011-2014).
• An increase was also noted in CD prevalence in children from 2010 (0.10%) to 2014 (0.17%).
• 34 patients (34%) presented with classical CD symptoms, 43 (43%) had nonclassical CD, and 23 (23%) were diagnosed by screening asymptomatic high-risk patients.
• Thirty-six patients (36%) suffering from complete villous atrophy, 51 (51%) had partial atrophy, and 11 (11%) had increased intraepithelial lymphocytes.
• Two patients were diagnosed without biopsy.
• Maximum patients (67%) reported a normal body mass index, 17% were overweight/obese, and only 9% were underweight.