Coeliac Disease More Common than Previously Thought

A new approach to detecting coeliac disease has revealed there are more people with the disorder than previously thought.

In a study of more than 2500 Victorians, researchers found more than half had genetic risk factors for developing coeliac disease, however it is not yet known why the disease develops in some people. The newly developed testing strategy showed coeliac disease potentially affected at least one in 60 Australian women and one in 80 men. Previous estimates had the number of Australians with coeliac disease as no more than one in 100.

Dr Jason Tye-Din from the Immunology division at the Walter and Eliza Hall Institute and Dr Bob Anderson, chief scientific officer at US biotechnology company ImmusanT, worked with Barwon Health, Deakin University, Healthscope Pathology and the University of Queensland Diamantina Institute to develop and trial the new diagnostic approach.

Dr Tye-Din said the new approach of combining the genetic test with a panel of antibody tests would increase the accuracy of testing, decrease overall medical costs by reducing invasive diagnostic tests, and avoid medically unnecessary use of a gluten-free diet.

“Currently, bowel biopsies are recommended for anybody with positive antibody tests,” he said. “In this study the inclusion of a simple genetic test helped identify a substantial number of people whose antibody tests were falsely positive and who did not actually require a bowel biopsy to test for the possibility of coeliac disease.”

Dr Tye-Din, who is also a gastroenterologist at The Royal Melbourne Hospital, said the findings were surprising and shed new light on the medical burden of coeliac disease in Australia. “It is concerning that a significant number of people in the community with coeliac disease have not been diagnosed,” he said. “Accurate and timely diagnosis is important for the health of patients with coeliac disease. Making a diagnosis based on a blood test alone or commencing a gluten-free diet without a confirmatory bowel biopsy is inappropriate and can impose an unnecessary and lifelong treatment.

“Although small bowel biopsy is needed to confirm coeliac disease it is costly and invasive. “Reducing unnecessary procedures is better for patients, eliminating an invasive test, and better for the economy by reducing healthcare costs,” Dr Tye-Din said. “This study provides a strategy to improve the diagnosis of coeliac disease in the community by combining the benefits of antibody and genetic testing.”

The research was funded by INOVA Diagnostics Inc, Nexpep Pty. Ltd, the NHMRC, the Victorian Health Promotion Foundation, the Geelong Region Medical Research Foundation, and the Victorian government