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Piattaforma informativa per esperti sulla celiachia e sensibilità al glutine non celiaca.

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Prevalenza della celiachia

La celiachia è una delle intolleranze più diffuse al mondo. In alcuni paesi la percentuale della popolazione colpita dalla malattia raggiunge l’un per cento, come mostrano i risultati di alcuni screening. In Italia la prevalenza risulta essere intorno allo 0,27%.
Per molto tempo la celiachia è stata considerata una rara patologia infantile. 20 anni fa la sua prevalenza oscillava ancora tra 1 : 1.000 e 1 : 2.000. Questi dati si basano sul manifestarsi di patologie conclamate e tipiche forme di celiachia. La scoperta di varie tipologie di anticorpi specifici per la celiachia e gli screening degli ultimi anni hanno dimostrato che la celiachia è molto più diffusa di quanto si creda. Le donne hanno il 50 per cento di probabilità in più di ammalarsi di celiachia rispetto agli uomini. In alcuni paesi è stata descritta una prevalenza della celiachia che oscilla tra 1 : 100 e 1 : 500. Ciò significa che l’un per cento della popolazione è affetto da celiachia.
 

Planisfero della celiachia

Uno studio pubblicato nel 2014 mostra che l’incidenza della celiachia è quintuplicata negli ultimi 25 anni. Tra le regioni caratterizzate da una prevalenza che raggiunge l’un per cento della popolazione vi sono l’Europa e gli Stati Uniti, dove l’alimentazione tradizionalmente si basa su alimenti ricchi di glutine. Una frequenza simile a quella europea è stata riscontrata anche nelle popolazioni dell’Africa settentrionale, del Vicino Oriente e dell’India.
 

Iceberg della celiachia

La maggior parte dei casi di celiachia sono asintomatici, non mostrano alcun decorso tipico e restano a lungo non diagnosticati. Il lasso di tempo che intercorre tra il manifestarsi dei primi sintomi e la diagnosi della celiachia può estendersi a sette anni. È stato calcolato che a un caso diagnosticato corrispondono da tre a cinque casi non diagnosticati. Per questo motivo si parla spesso di “iceberg della celiachia”.
 

Picco di età della celiachia

Ormai accade sempre più di frequente che la celiachia sia diagnosticata in età adulta. Se prima del 1981 l’età media dei pazienti alla prima diagnosi si aggirava intorno ai 30 anni, oggi è compresa tra i 40 e i 45 anni. Con l’avanzare dell’età si è modificato anche il quadro clinico della patologia: molti pazienti a cui la malattia è stata diagnosticata in età adulta, presentano i sintomi extra intestinali propri di una celiachia sintomatica.
Dr. Schär Institute Epidemiologia celiachia Intolleranza al glutine Iceberg della celiachia
Iceberg della celiachia: Dal momento che la maggior parte dei casi di celiachia non vengono diagnosticati a causa di una sintomatologia non specifica, si parla un “fenomeno iceberg” della celiachia.
Fonti
  • 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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La mappa mondiale della celiachia

In questo articolo parleremo di come varia la frequenza della celiachia “nel tempo e nello spazio”. Questa infor-mazione è molto importante non solo per la rilevanza statistica, ma in quanto permette di formulare ipotesi sui fattori che possono influenzare lo sviluppo di questa patologia, tanto diffusa nella società attuale.

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Autore:
Catassi, C;
Anno:
2014

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
 
Anno:
2014 dicembre
Lingue:
English;

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
 
Autore:
Catassi, C; Gatti, S; Fasano, A;
Anno:
2014 luglio
Lingue:
English;

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
 
Autore:
West, J; Fleming, K; Tata, L; et al.;
Anno:
2014 maggio
Lingue:
English;

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
 
Anno:
2014 marzo
Lingue:
English;
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