Prévalence de la maladie cœliaque
La maladie cœliaque est l’une des intolérances les plus répandues au monde. Les chiffres des dépistages de masse montrent qu’elle touche jusqu’à 1% de la population. En France la prévalence de la maladie coeliaque n’est pas connue; sa fréquence est estimée comme pour les autres pays occidentaux à 1%.
Longtemps, on a cru que la maladie cœliaque était une maladie infantile rare. Il y a vingt ans encore, la prévalence allait de 1 sur 1.000 à 1 sur 2.000. Ces chiffres s’appuient sur l’apparition des symptômes caractéristiques de la maladie cœliaque. Grâce à l’identifiction des anticorps de la maladie cœliaque et au développement des protocoles de dépistage de ces dernières années, il s‘avère que la maladie cœliaque est bien plus répandue qu’on ne le pense.En particulier, chez les femmes qui sont deux fois plus touchées que les hommes. En France 1% de la population est potentiellement concernée.
Carte mondiale de la pathologie
Une étude publiée en 2014 montre que l’incidence de la maladie cœliaque a été multipliée par 5 dans les 25 dernières années. Parmi les contrées à forte prévalence (jusqu’à 1%), on compte l‘Europe et les États-Unis dans lesquels l’alimentation de base est traditionnellement riche en produits contenant du gluten. On retrouve une fréquence identique dans les populations d‘Afrique du Nord, du Proche-Orient et d’Inde.La partie visible de l‘iceberg
Les cas de maladie cœliaque sont pour la plupart asymptomatiques, c'est-à-dire qu’ils ne se présentent pas sous la forme typique et n’évoluent pas de la même manière. La maladie passe donc le plus souvent inaperçue. Le laps de temps qui s’écoule entre l'apparition des premiers symptômes et le diagnostic de la maladie cœliaque peut durer sept ans. Pour un malade diagnostiqué on compte trois à cinq personnes non diagnostiqués. On illustre cette maladie par un iceberg puisque beaucoup de cas restent encore à découvrir.Pyramide des âges de la maladie cœliaque
A l’heure actuelle, la maladie cœliaque est de plus en plus souvent diagnostiquée à l'âge adulte. Avant 1980, l’âge moyen des patients diagnostiqués était de 30 ans. Aujourd’hui, il se situe entre 40 et 45 ans. Quand le patient avance en âge, les signes cliniques se modifient. Beaucoup de patients n’étant diagnostiqués qu‘à l'âge adulte, ils présentent alors une maladie cœliaque symptomatique qui s’accompagnent de symptômes extra-intestinaux.
Iceberg de la maladie cœliaque: La plupart des cas de maladie cœliaque n’étant pas découverts faute de symptômes caractéristiques, on illustre la maladie cœliaque par un « iceberg ».
Sources
- Catassi C., Gatti S., Fasano A. The New Epidemiology of Celiac Disease Journal of Pediatric Gastroenterology & Nutrition, July 2014 Volume 59.
- Mustalahti et al., The prevalence of celiac disease in Europe: Results of a centralized, international mass screening project. Annals of Medicine 2010 Dec;42(8):587-95.
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Fichier « Conseils et outils pour la prise en charge diététique de la maladie coeliaque »
La carte du monde de la maladie cœliaque
Cet article aborde la fréquence de la maladie cœliaque qui varie en fonction « du temps et de l’espace ». Cette information ne sert pas seulement à des fins statistiques, mais avant tout à formuler des hypothèses sur les facteurs qui contribuent au développement de cette pathologie si répandue dans la société actuelle.
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La carte du monde de la maladie cœliaque
Cet article aborde la fréquence de la maladie cœliaque qui varie en fo...
Is gluten the great etiopathogenic agent of disease in the XXI century?
Abstract
Introduction: Gluten is a glycoprotein present in some cereals. The incidence of disorders related to gluten, including the EC, is increasing, even pathologies far from an etiology or treatment with GFD.
Aims: Review the scientific literature related to the ingestion of gluten and pathogenesis of different diseases.
Methods: A literature search in major scientific database.
Results: We obtained from the following diseases, gluten ataxia, multiple sclerosis, autism spectrum disorder, schizophrenia, attention deficit hyperactivity disorder, depressive disorders, headaches, irritable bowel syndrome, fibromyalgia, dermatitis herpetiformis and epilepsy, studies in which either a determination of gliadin was referred or a treatment, with/without gluten, was applied and evaluated.
Conclusion: The ingestion of gluten seems to be related to disease, when there is no EC, SGNC or wheat allergy. Suspicions about the benefit of GFD as a complementary treatment is borne in semi-clinical trials and cohorts, either as a causal factor in the pathogenesis, or improvement of symptoms.
Resource: Nutr Hosp. 2014;30(6):1203-1210
Ismael San Mauro Martín, Elena Garicano Vilar, Luis Collado Yurrutia y María José Ciudad Cabañas
Introduction: Gluten is a glycoprotein present in some cereals. The incidence of disorders related to gluten, including the EC, is increasing, even pathologies far from an etiology or treatment with GFD.
Aims: Review the scientific literature related to the ingestion of gluten and pathogenesis of different diseases.
Methods: A literature search in major scientific database.
Results: We obtained from the following diseases, gluten ataxia, multiple sclerosis, autism spectrum disorder, schizophrenia, attention deficit hyperactivity disorder, depressive disorders, headaches, irritable bowel syndrome, fibromyalgia, dermatitis herpetiformis and epilepsy, studies in which either a determination of gliadin was referred or a treatment, with/without gluten, was applied and evaluated.
Conclusion: The ingestion of gluten seems to be related to disease, when there is no EC, SGNC or wheat allergy. Suspicions about the benefit of GFD as a complementary treatment is borne in semi-clinical trials and cohorts, either as a causal factor in the pathogenesis, or improvement of symptoms.
Resource: Nutr Hosp. 2014;30(6):1203-1210
Ismael San Mauro Martín, Elena Garicano Vilar, Luis Collado Yurrutia y María José Ciudad Cabañas
The New Epidemiology of Celiac Disease
Abstract
The prevalence of celiac disease (CD) varies greatly, but several reports have shown that CD is increasing in frequency in different geographic areas. The increase in prevalence can be partially attributed to the improvement in diagnostic techniques and disease awareness; however the equally well documented rise in incidence in the last 30–40 years cannot be so easily explained. The new epidemiology of CD is now characterized by an increase of new cases in the historical CD areas (northern Europe and the United States) and more interestingly in a spread of the disease in new regions (Asian countries). A significant change in diet habits, particularly in gluten consumption as well as in infant feeding patterns are probably the main factors that can account for these new trends in CD epidemiology.
Resource: Journal of Pediatric Gastroenterology & Nutrition, July 2014 Volume 59
The prevalence of celiac disease (CD) varies greatly, but several reports have shown that CD is increasing in frequency in different geographic areas. The increase in prevalence can be partially attributed to the improvement in diagnostic techniques and disease awareness; however the equally well documented rise in incidence in the last 30–40 years cannot be so easily explained. The new epidemiology of CD is now characterized by an increase of new cases in the historical CD areas (northern Europe and the United States) and more interestingly in a spread of the disease in new regions (Asian countries). A significant change in diet habits, particularly in gluten consumption as well as in infant feeding patterns are probably the main factors that can account for these new trends in CD epidemiology.
Resource: Journal of Pediatric Gastroenterology & Nutrition, July 2014 Volume 59
Incidence and Prevalence of Celiac Disease and Dermatitis Herpetiformis in the UK Over Two Decades: Population-Based Study
Abstract
OBJECTIVES:
Few studies have quantified the incidence and prevalence of celiac disease (CD) and dermatitis herpetiformis (DH) nationally and regionally by time and age groups. Understanding this epidemiology is crucial for hypothesizing about causes and quantifying the burden of disease.
METHODS:
Patients with CD or DH were identified in the Clinical Practice Research Datalink between 1990 and 2011. Incidence rates and prevalence were calculated by age, sex, year, and region of residence. Incidence rate ratios (IRR) adjusted for age, sex, and region were calculated with Poisson regression.
RESULTS:
A total of 9,087 incident cases of CD and 809 incident cases of DH were identified. Between 1990 and 2011, the incidence rate of CD increased from 5.2 per 100,000 (95% confidence interval (CI), 3.8–6.8) to 19.1 per 100,000 person-years (95% CI, 17.8–20.5; IRR, 3.6; 95% CI, 2.7–4.8). The incidence of DH decreased over the same time period from 1.8 per 100,000 to 0.8 per 100,000 person-years (average annual IRR, 0.96; 95% CI, 0.94–0.97). The absolute incidence of CD per 100,000 person-years ranged from 22.3 in Northern Ireland to 10 in London. There were large regional variations in prevalence for CD but not DH.
CONCLUSIONS:
We found a fourfold increase in the incidence of CD in the United Kingdom over 22 years, with large regional variations in prevalence. This contrasted with a 4% annual decrease in the incidence of DH, with minimal regional variations in prevalence. These contrasts could reflect differences in diagnosis between CD (serological diagnosis and case finding) and DH (symptomatic presentation) or the possibility that diagnosing and treating CD prevents the development of DH.
Resource: Am J Gastroenterol. May 2014
OBJECTIVES:
Few studies have quantified the incidence and prevalence of celiac disease (CD) and dermatitis herpetiformis (DH) nationally and regionally by time and age groups. Understanding this epidemiology is crucial for hypothesizing about causes and quantifying the burden of disease.
METHODS:
Patients with CD or DH were identified in the Clinical Practice Research Datalink between 1990 and 2011. Incidence rates and prevalence were calculated by age, sex, year, and region of residence. Incidence rate ratios (IRR) adjusted for age, sex, and region were calculated with Poisson regression.
RESULTS:
A total of 9,087 incident cases of CD and 809 incident cases of DH were identified. Between 1990 and 2011, the incidence rate of CD increased from 5.2 per 100,000 (95% confidence interval (CI), 3.8–6.8) to 19.1 per 100,000 person-years (95% CI, 17.8–20.5; IRR, 3.6; 95% CI, 2.7–4.8). The incidence of DH decreased over the same time period from 1.8 per 100,000 to 0.8 per 100,000 person-years (average annual IRR, 0.96; 95% CI, 0.94–0.97). The absolute incidence of CD per 100,000 person-years ranged from 22.3 in Northern Ireland to 10 in London. There were large regional variations in prevalence for CD but not DH.
CONCLUSIONS:
We found a fourfold increase in the incidence of CD in the United Kingdom over 22 years, with large regional variations in prevalence. This contrasted with a 4% annual decrease in the incidence of DH, with minimal regional variations in prevalence. These contrasts could reflect differences in diagnosis between CD (serological diagnosis and case finding) and DH (symptomatic presentation) or the possibility that diagnosing and treating CD prevents the development of DH.
Resource: Am J Gastroenterol. May 2014
Coeliac disease
Summary points
Adult coeliac disease is a common autoimmune condition with an estimated prevalence of 1%. Test for coeliac disease in patients with unexplained anaemia, weight loss, diarrhoea, or gastrointestinal symptoms, particularly irritable bowel syndrome, and in first degree relatives of index cases. Confirm the diagnosis with duodenal biopsy in all adult patients. Treatment with a lifelong strict gluten-free diet is currently the only treatment of known effectiveness. Patients should have access to an expert dietitian for advice on a gluten-free diet and for assessment of adherence if symptoms persist on institution of the diet. Regular follow-up is necessary to assess adherence and micronutrient deficiency.
Coeliac disease is a common autoimmune condition characterised by a heightened immunological response to ingested gluten, with estimated prevalence rates in adults of 0.2-1% in the United States and Europe. Contemporary studies suggest that the prevalence of this disease is increasing.3 4 5 Meta-analyses have shown that for every patient identified as having coeliac disease seven to eight remain undiagnosed. Here, we will summarise recent evidence on how the investigation and diagnosis of coeliac disease can be improved and also provide an evidence based approach to managing patients with newly diagnosed coeliac disease and those who do not respond to a gluten-free diet as expected. Evidence is taken from meta-analyses, systematic reviews, and randomised controlled trials where possible.
Sources and selection criteria
We searched Medline and the Cochrane Database of Systematic Reviews with the search terms “coeliac disease” or “celiac disease”. Studies included those in adult and paediatric populations but preference was given to adult studies in the past five years. We focused on meta-analyses and systematic reviews where possible.
Who gets coeliac disease?
In the past coeliac disease was considered to be a disease that affects white populations only, but it is now clear that coeliac disease is a global problem. Clinicians in …
Resource: BMJ 2014; (Published 3 March 2014)
Peter D Mooney, clinical research fellow gastroenterology, Marios Hadjivassiliou, professor of neurology and NHS consultant, David S Sanders, professor of gastroenterology and NHS consultant
Adult coeliac disease is a common autoimmune condition with an estimated prevalence of 1%. Test for coeliac disease in patients with unexplained anaemia, weight loss, diarrhoea, or gastrointestinal symptoms, particularly irritable bowel syndrome, and in first degree relatives of index cases. Confirm the diagnosis with duodenal biopsy in all adult patients. Treatment with a lifelong strict gluten-free diet is currently the only treatment of known effectiveness. Patients should have access to an expert dietitian for advice on a gluten-free diet and for assessment of adherence if symptoms persist on institution of the diet. Regular follow-up is necessary to assess adherence and micronutrient deficiency.
Coeliac disease is a common autoimmune condition characterised by a heightened immunological response to ingested gluten, with estimated prevalence rates in adults of 0.2-1% in the United States and Europe. Contemporary studies suggest that the prevalence of this disease is increasing.3 4 5 Meta-analyses have shown that for every patient identified as having coeliac disease seven to eight remain undiagnosed. Here, we will summarise recent evidence on how the investigation and diagnosis of coeliac disease can be improved and also provide an evidence based approach to managing patients with newly diagnosed coeliac disease and those who do not respond to a gluten-free diet as expected. Evidence is taken from meta-analyses, systematic reviews, and randomised controlled trials where possible.
Sources and selection criteria
We searched Medline and the Cochrane Database of Systematic Reviews with the search terms “coeliac disease” or “celiac disease”. Studies included those in adult and paediatric populations but preference was given to adult studies in the past five years. We focused on meta-analyses and systematic reviews where possible.
Who gets coeliac disease?
In the past coeliac disease was considered to be a disease that affects white populations only, but it is now clear that coeliac disease is a global problem. Clinicians in …
Resource: BMJ 2014; (Published 3 March 2014)
Peter D Mooney, clinical research fellow gastroenterology, Marios Hadjivassiliou, professor of neurology and NHS consultant, David S Sanders, professor of gastroenterology and NHS consultant
Is gluten the great etiopathogenic agent of disease in the XXI century?
Abstract
Introduction: Gluten is a glycoprotein present in some cer...
The New Epidemiology of Celiac Disease
Abstract
The prevalence of celiac disease (CD) varies greatly, but ...
Incidence and Prevalence of Celiac Disease and Dermatitis Herpetiformis in the UK Over Two Decades: Population-Based Study
Abstract
OBJECTIVES:
Few studies have quantified the incidence and...
Coeliac disease
Summary points
Adult coeliac disease is a common autoimmune conditi...
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