Celiac disease in non-clinical populations of Japan

• Published in: Journal of gastroenterology Vol. 53; no. 2; pp. 208 - 214
• Main Authors: Fukunaga, Mai, Ishimura, Norihisa, Fukuyama, Chika, Izumi, Daisuke, Ishikawa, Nahoko, Araki, Asuka, Oka, Akihiko, Mishiro, Tomoko, Ishihara, Shunji, Maruyama, Riruke, Adachi, Kyoichi, Kinoshita, Yoshikazu
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.02.2018; Springer; Springer Nature B.V
• Subjects: Abdominal Pain - epidemiology; Abdominal Pain - etiology; Abdominal Surgery; Adult; Age Distribution; Aged; Autoantibodies - blood; Biopsy; Celiac disease; Celiac Disease - complications; Celiac Disease - epidemiology; Celiac Disease - immunology; Celiac Disease - pathology; Colorectal Surgery; Comorbidity; Diarrhea - epidemiology; Diarrhea - etiology; Duodenoscopy; Duodenum - pathology; Female; Gastroenterology; Gluten; Hepatology; Histocompatibility antigen HLA; Humans; Immunoglobulin A; Immunoglobulin A - blood; Intestinal Mucosa - pathology; Japan - epidemiology; Male; Medical colleges; Medical research; Medical screening; Medicine; Medicine & Public Health; Medicine, Experimental; Middle Aged; Mucosa; Original Article—Alimentary Tract; Population studies; Prevalence; Small intestine; Surgical Oncology; Tissue typing; Transglutaminase 2; Transglutaminases - immunology; Japan; Anti-tissue transglutaminase IgA; Celiac disease; HLA; Antibody
• ISSN: 0944-1174; 1435-5922; 1435-5922
• DOI: 10.1007/s00535-017-1339-9

Background Celiac disease is a chronic autoimmune enteropathy caused by gluten ingestion. While its prevalence in Western countries is reported to be as high as 1%, the prevalence has not been evaluated in a large-scale study of a Japanese population. The aim of our study was to clarify the possible presence of celiac disease in a Japanese non-clinical population as well as in patients showing symptoms suggestive of the disease. Methods Serum samples were collected from 2008 non-clinical adults and 47 patients with chronic unexplained abdominal symptoms between April 2014 and June 2016. The anti-tissue transglutaminase (TTG) immunoglobulin A antibody titer was determined as a screening test for celiac disease in all subjects, and individuals with a value of >2 U/mL subsequently underwent testing for the presence of serum endomysial IgA antibody (EMA) as confirmation. Those testing positive for EMA or with a high concentration (>10 U/mL) of TTG were further investigated by histopathological examinations of duodenal mucosal biopsy specimens and HLA typing tests. Results Of the 2008 non-clinical adults from whom serum samples were collected, 161 tested positive for TTG, and all tested negative for EMA. Four subjects who had a high TTG titer were invited to undergo confirmatory testing, and the histopathological results confirmed the presence of celiac disease in only a single case (0.05%). Of the 47 symptomatic patients, one (2.1%) was found to have a high TTG titer and was diagnosed with celiac disease based on duodenal histopathological findings. Conclusion The presence of celiac disease in a non-clinical Japanese population was low at 0.05% and was rarely found in patients with unexplained chronic abdominal symptoms.