Prevalence of IgA-antiendomysial antibody in a patient cohort with idiopathic low bone mineral density

AIM:To investigate the frequency of serum IgA-antiendomysial antibody positivity in patients with low bone mineral density and to assess the risk group for screening of celiac disease. METHODS:One hundred and thirty-five patients (14 male,121 female) with idiopathic low bone mineral density were evaluated. The median age was 57.2 years (24-81). Antiendomysial antibody was determined by the immunofluorescence method using a commercial kit (INOVA Diagnostics Inc.,CA,USA),which employs a 5 μm thin cryostat section of monkey esophagus as a substrate. RESULTS:Of the 135 patients evaluated,13 were found to have positive IgA antiendomysial antibody test (9.6%) response. None of the patients had IgA deficiency. Endoscopic appearance and histological examination were normal in all of these patients. Seropositive patients had significantly lower age (48.9 ± 4.3 vs 59.2 ± 6.2,P < 0.05),higher ratio of male gender (61.5% vs 4.9%,P < 0.01) and pre-menopausal status (8.7% vs 1.3%,P < 0.01). Lumbar spine and femoral neck z-scores,but not t-scores were significantly lower in seropositive patients. Seropositive patients had lower serum 25 (OH) vitamin D,calcium and higher serum parathormone levels than seronegative patients. CONCLUSION:The screening of celiac disease in idiopathic osteoporosis should be restricted to patients without classical risk factors (younger,pre-menopausal,male gender) for osteoporosis. Bone mineral density measurements using z-scores should be considered for identifying risk groups for celiac disease.

Seroprevalence of celiac disease among healthy adolescents in Saudi Arabia

AIM: To identify the seroprevalence of celiac disease among healthy Saudi adolescents. METHODS: Between December 2007 and January 2008, healthy students from the 10th to 12th grades were randomly selected from three regions in Saudi Arabia. These regions included the following: (1) Aseer region, with a student population of 25512; (2) Madinah, with a student population of 23852; and (3) Al-Qaseem, with a student population of 16067. Demographic data were recorded, and a venous blood sample (5-10 mL) was taken from each student. The blood samples were tested for immunoglobulin A and immunoglobulin G endomysial antibodies (EMA) by indirect immunofluorescence.RESULTS: In total, 1167 students (614 males and 553 females) from these three regions were randomly selected. The majority of the study population was classified as lower middle class (82.7%). There were 26 (2.2%) students who had a positive anti-EMA test, including 17 females (3.1%) and 9 males (1.5%). Al-Qaseem region had the highest celiac disease prevalence among the three studied regions in Saudi Arabia (3.1%). The prevalence by region was as follows: Aseer 2.1% (10/479), Madinah 1.8% (8/436), and Al-Qaseem 3.2% (8/252). The prevalence in Madinah was significantly lower than the prevalence in Aseer and Al-Qaseem (P=0.02). CONCLUSION: Our data suggest celiac disease prevalence might be one of the highest in the world. Further studies are needed to determine the real prevalence.