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High prevalence of coeliac disease in apparently healthy Iranian blood donors

Shahbazkhani, Bijana; Malekzadeh, Rezaa; Sotoudeh, Masouda; Moghadam, Ketaion Fayaza; Farhadi, Mohammada; Ansari, Rezaa; Elahyfar, Amina; Rostami, Kamranb

European Journal of Gastroenterology & Hepatology: May 2003 - Volume 15 - Issue 5 - p 475‐478
doi: 10.1097/01.meg.0000059118.41030.96
Article

Background/objective: Studies about the prevalence of coeliac disease in countries in western Asia are scarce and there is no study on the prevalence of coeliac disease in Iran. The aim of this study was to determine the prevalence of coeliac in healthy, Iranian, blood donors.

Study design and methods: Blood samples were obtained from 2000 apparently healthy blood donors (1580 males, 420 females; mean age 35.5 years, range 18‐65 years) at the Tehran Blood Donation Centre during a 4 month period from November 1998 through February 1999. Total serum IgA was measured in all donors, and IgA deficient cases were excluded. All cases were analysed for IgA anti‐gliadin (AGA) by an ELISA test and those with positive results were tested for IgA anti‐endomysium antibody (EMA) using immunofluorescence. All donors who had a positive serology for both AGA and EMA underwent small intestinal biopsy. The biopsy samples were classified according to revised Marsh criteria (UEGW 2001).

Results: Forty‐nine cases showed positive IgA AGA (38 males and 11 females, mean age 38.6 years). Of the 49 AGA positive cases 12 were EMA positive. All subjects with positive serology (both AGA and EMA) were found to have small bowel biopsies compatible with gluten sensitive enteropathy. Three of 12 had Marsh I, 4/12 Marsh II and 5/12 showed a Marsh IIIa lesion.

Conclusion: The minimum prevalence of gluten sensitivity among apparently healthy urban Iranian blood donors is 1/166. Further epidemiological studies in adults from the general population and in high risk groups seems indicated.

aDigestive Disease Research Centre, Tehran University of Medical Sciences, Iran; and bWeston General Hospital Department of Medicine, Weston‐super‐Mare, UK.

This study was supported by a grant from the Digestive Disease Research Centre, Tehran University of Medical Sciences, Tehran, Iran.

Correspondence to Prof. Reza Malekzadeh, Digestive Disease Research Centre, Shariati Hospital, North Kargar Avenue, Tehran, Iran. Tel: +98 21 801 2992; fax: +98 21 2253635; e‐mail: malek@ams.ac.ir

Received 25 April 2002 Revised 6 November 2002 Accepted 16 December 2002

© 2003 Lippincott Williams & Wilkins, Inc.