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COELIAC DISEASE

A deep dive into the submerged ‘coeliac iceberg’

Nature Reviews Gastroenterology & Hepatology volume 18, page 748 (2021)Cite this article

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In 1991, Richard Logan introduced the idea of a ‘coeliac iceberg’ as a metaphor for the overall number of coeliac disease cases. Clinically overt cases are above the surface, and asymptomatic individuals with silent or latent disease are the submerged part of the iceberg.

At the time, most of the scientific papers on coeliac disease came from Italy, Ireland and Nordic countries/territories, where prevalence was reportedly the highest. In the United States, two epidemiological studies performed in 1993 and 1994 had shown an extremely low prevalence of coeliac disease. However, these studies had failed to consider the atypical and silent forms. Some data from Africa, Asia and South America had by then started to show that coeliac disease prevalence was more common than previously thought.

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References

Original article

  • Fasano, A. et al. Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Arch. Intern. Med. 163, 286–292 (2003)

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  1. Gastroenterology Department, School of Medicine, Universidad de la República, Montevideo, Uruguay

    Carolina Olano

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  1. Carolina Olano
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Correspondence to Carolina Olano.

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Olano, C. A deep dive into the submerged ‘coeliac iceberg’. Nat Rev Gastroenterol Hepatol 18, 748 (2021). https://doi.org/10.1038/s41575-021-00510-9

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  • DOI: https://doi.org/10.1038/s41575-021-00510-9

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