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Celiac disease in non-clinical populations of Japan

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Abstract

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.

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Acknowledgments

The authors thank Takashi Toda, and Atsuko Konishi (Shimane Environment and Health Public Corporation) for blood sample preparation. We also thank Keiko Masuzaki (Shimane University School of Medicine) for excellent technical assistance.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Shimane University School of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan

    Mai Fukunaga, Norihisa Ishimura, Chika Fukuyama, Daisuke Izumi, Akihiko Oka, Shunji Ishihara & Yoshikazu Kinoshita

  2. Department of Pathology, Shimane University School of Medicine, Izumo, Japan

    Nahoko Ishikawa, Asuka Araki & Riruke Maruyama

  3. Health Center, Shimane Environment and Health Public Corporation, Matsue, Japan

    Tomoko Mishiro & Kyoichi Adachi

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  1. Mai Fukunaga
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Correspondence to Norihisa Ishimura.

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Fukunaga, M., Ishimura, N., Fukuyama, C. et al. Celiac disease in non-clinical populations of Japan. J Gastroenterol 53, 208–214 (2018). https://doi.org/10.1007/s00535-017-1339-9

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  • DOI: https://doi.org/10.1007/s00535-017-1339-9

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