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European and North American populations should be screened for coeliac disease

A Fasano

Correspondence to:
A Fasano Division of Pediatric GI and Nutrition, Center for Celiac Research, University of Maryland School of Medicine, P.O. Box 140, 22 S Greene St, Baltimore, MD, USA;
afasano@peds.umaryland.edu

Accepted 9 September 2002

Keywords: coeliac disease; screening

The first 150 words of the full text of this article appear below.

Coeliac disease (CD) is an immune mediated enteropathy triggered by ingestion of gluten containing grains in genetically susceptible individuals.¹ CD is associated with HLA alleles DQ2 and/or DQ8, and in the continued presence of gluten the disease is self perpetuating.^1,2 To sustain the position that active screening in search of CD cases is a justified policy, we will review the WHO guidelines for disease mass screening recommendations to establish whether CD satisfies these criteria.³

1. Early detection of the disease could be difficult on a clinical basis.
   
2. The disease must be a common disorder causing significant morbidity in the general population.
   
3. The screening tests must be highly sensitive and specific for the target disease.
   
4. A treatment for the disease must be available.
   
5. If not recognised, the disease could result in severe complications difficult to manage.
   

CD can manifest with a previously unsuspected range of clinical presentations, including the typical malabsorption syndrome . . . [Full text of this article]

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eLetters:

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Coeliac disease: is case-finding the correct ethical and logistical approach?

David S Sanders

Gut Online, 27 Feb 2003 [Full text]

Author's reply

Alessio Fasano

Gut Online, 6 Mar 2003 [Full text]