Celiac disease could be a frequent disease in Mexico:: Prevalence of tissue transglutaminase antibody in healthy blood donors

Introduction/Aim: In North America and Europe, the prevalence of celiac disease (CD) might be much greater than expected in previous estimates. Until recently, the prevalence of CD in Latin America remained largely unknown. So far, information regarding CD in Mexico is limited, and it is still considered a rare disease. Our aim was to determine the prevalence of tTGA in a large group of apparently healthy blood donors. Subjects and Methods: Serum samples from 1009 consecutive blood donors, who attended a third level referral center in Mexico City, were collected between June 2004 and December 2004. Only Mexican Mestizo individuals were included. All sera were tested with a new generation human recombinant protein based tTGA-IgA ELISA commercial kit (Aeskulisa tTG-IgA, Wendelsheim, Germany). The cut-off value provided by the manufacturer was 15 U/mL. Results: The mean age of the blood donors was 34 +/- 10 years and 68% (n = 683) were men. Six hundred fifty two subjects (65%) were born in Mexico City; and from the remaining 357 subjects, at least one was born in each of the 31 different states in our country. Twenty-seven (2.7%) blood donors were positive for tTGA-IgA; all of them with tTGA-IgA values above 30 U/mL (range 36 to 1639). Overall prevalence was 1:37 [27/1009, 95% confidence interval (CI) = 1.6-3.71. The prevalence among women was 1:33 (10/326, 95% CI = 1.04-5.09) and for men 1:40 (17/683, 95% CI = 1.24-3.73). Conclusions: On the basis of a well-recognized serologic screening method performed to blood donor samples, we demonstrated an unexpectedly high prevalence of tTGA positivity (2.6%) in the adult Mexican Mestizo population. Thus, the prevalence of CD in Mexico could be higher or similar to that observed in other countries. This observation contributes to increase the awareness for this under diagnosed disease in clinical practice and to consider CD as a global health problem.