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In the recently published debate in Gut regarding the utility of mass screening of European and North American populations for coeliac disease (CD), divergent conclusions were presented (Gut 2003;52:168–9 and 170–1). In this context, the increased utility of screening adults for CD in those presenting with concomitant morbidity (for example, metabolic bone disease and fracture) was raised. To support such an hypothesis, evidence of either an increased fracture rate in those with CD or, alternatively, an increased incidence of CD in those presenting with fracture would be required.
Thomason and colleagues,1 in a study of 244 patients with CD and 161 age and sex matched controls, addressed the first of these possibilities. They found that patients with …