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Undiagnosed coeliac disease at age seven: population based prospective birth cohort study

BMJ 2004; 328 doi: (Published 05 February 2004) Cite this as: BMJ 2004;328:322
  1. Polly J Bingley, reader (,
  2. Alastair J Norcross, research assistant1,
  3. Robert J Lock, principal clinical scientist2,
  4. Andrew R Ness, deputy director (epidemiology), ALSPAC3,
  5. Richard W Jones, head of biological collections, ALSPAC, Avon Longitudinal Study of Parents and Children Study Team3
  1. 1Division of Medicine, University of Bristol, Southmead Hospital, Bristol BS10 5NB
  2. 2Department of Immunology, North Bristol NHS Trust, Southmead Hospital, Bristol BS10 5NB
  3. 3Unit of Paediatric and Perinatal Epidemiology, Division of Child Health, University of Bristol, Bristol BS8 1TQ
  1. Correspondence to: P J Bingley
  • Accepted 11 August 2003


Coeliac disease is uncommon in childhood and diagnosed in fewer than 1 in 2500 children in the United Kingdom.1 Subclinical disease is, however, common in adults, and can be detected by testing for serum IgA antiendomysial antibodies (IgA-EMA).2 We aimed to establish the prevalence of undiagnosed coeliac disease in the general population at age seven, and to look for associated clinical features.

Participants, methods, and results

We studied children aged 7.5 years participating in the Avon Longitudinal Study of Parents and Children (ALSPAC), a population based birth cohort study established in 1990.3 Two stage screening included a sensitive initial radioimmunoassay for antibodies to tissue transglutaminase (endomysial antigen) with further testing of positive samples for IgA-EMA by indirect immunofluorescence.4 Children with tTG antibodies below the 97.5th centile were defined as antibody negative. Height, weight, and haemoglobin levels were measured at dedicated study clinics. Details of gastrointestinal symptoms and special diets were collected by routine questionnaire at age 6.75 years.

Of …

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