The number of young children diagnosed with coeliac disease in the UK has almost tripled over the past 20 years, but kids from poorer families are only half as likely to be diagnosed with the condition, reveals research published online in Archives of Disease in Childhood.
The evidence to date suggests that up to 1% of all children in the UK have blood markers for coeliac disease, an autoimmune reaction to dietary gluten from wheat, barley, and rye.
In a bid to assess current diagnostic patterns, the research team assessed data contained in The Health Improvement Network (THIN), a representative UK database of anonymised primary care health records.
They identified all children from birth to the age of 18, registered with general practices across the UK that contribute to THIN, between 1993 and 2012.
Among the total of 2,063,421 children, 1247 had been diagnosed with coeliac disease during this period, corresponding to around 1 new case in every 10,000 children every year.
This case rate was similar across all four UK countries, and was 53% higher among girls than among boys. Between 1993 and 2012, diagnoses rose by 39% in boys, but doubled in girls.
While the numbers of new cases diagnosed in infants and toddlers remained fairly stable across all four countries, diagnoses among children older than 2 years almost tripled in the space of 20 years.The diagnosis rate for coeliac disease in 2008-12 among children was 75% higher than it was in 1993-97.
When the researchers analysed the social and economic backgrounds of children diagnosed with the condition, they found that those from less well-off backgrounds were only half as likely to be diagnosed with the condition. This pattern was evident for both boys and girls, and across all ages.
The researchers say the rise in new cases among children is likely to be the result of better awareness of coeliac disease, as well as the means to diagnose it. But this does not explain the differences in diagnoses among children from different socioeconomic backgrounds, they say.
“Based on the current evidence, the most plausible explanation for the socioeconomic gradient in the incidence of childhood coeliac disease whereby children from least deprived areas have [it] diagnosed more often than those from the most deprived areas is that ascertainment of disease varies, rather than the true occurrence of [coeliac disease],” they write.
Socioeconomic variation in the incidence of childhood coeliac disease in the UK, Fabiana Zingone, Joe West, Colin J Crooks, Kate M Fleming, Timothy R Card, Carolina Ciacci, Laila J Tata, Archives of Disease in Childhood, doi:10.1136/archdischild-2014-307105, published 22 January 2015.