Reviewer's report
Title:Increasing prevalence and high Incidence of celiac disease in elderly
people: A population-based study
Version: 1Date:2 March 2009
Reviewer: joseph murray
Reviewer's report:
This is a very important observation of the new development celiac disease in
older patients. it is of scientific and practical clinical importance.
Whilst there were new 5 elderly individuals identified with probable new onset
celiac disease, this is a small number whilst this is statistically significant in terms
of a change over prior. Could this change be due to variability in the testing
between the two time periods? This could be addressed by examining and
reporting the absolute values and arbitrary assay units between the two time
points. For example, were the earlier samples close to the threshold considered
abnormal for tissue transglutaminase antibody ? Repeating testing on both the
first and the subsequent sample at the same time for both tests to make sure this
truly was not simply variation around a threshold. The second issue is whether
there were any confounders occurring on the first time, such as the use of
steroids, be it topical or other immune modifiers.
2. Another second issue relates to the very high incidence of celiac disease in
this unique population. Is the population of Lahti particularly inbred or isolated? Is
there an especially high prevalence of homozygocity for DQ2, for example?
3. How would these results from this very isolated population relate to other
populations? Have the authors taken into account the possibilities that the
patients may have originally been seronegative celiac disease who then became
seropositive, but had celiac disease all along? Demonstration of the actual
histology would be convincing to this reviewer. Also, it would be worthwhile to
know what the prevalence of seronegative celiac disease or pre-celiac disease
could be in these individuals.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Reviewer's report
Title:Increasing prevalence and high Incidence of celiac disease in elderly
people: A population-based study
Version: 1Date:2 March 2009
Reviewer: joseph murray
Reviewer's report:
This is a very important observation of the new development celiac disease in
older patients. it is of scientific and practical clinical importance.
Whilst there were new 5 elderly individuals identified with probable new onset
celiac disease, this is a small number whilst this is statistically significant in terms
of a change over prior. Could this change be due to variability in the testing
between the two time periods? This could be addressed by examining and
reporting the absolute values and arbitrary assay units between the two time
points. For example, were the earlier samples close to the threshold considered
abnormal for tissue transglutaminase antibody ? Repeating testing on both the
first and the subsequent sample at the same time for both tests to make sure this
truly was not simply variation around a threshold. The second issue is whether
there were any confounders occurring on the first time, such as the use of
steroids, be it topical or other immune modifiers.
2. Another second issue relates to the very high incidence of celiac disease in
this unique population. Is the population of Lahti particularly inbred or isolated? Is
there an especially high prevalence of homozygocity for DQ2, for example?
3. How would these results from this very isolated population relate to other
populations? Have the authors taken into account the possibilities that the
patients may have originally been seronegative celiac disease who then became
seropositive, but had celiac disease all along? Demonstration of the actual
histology would be convincing to this reviewer. Also, it would be worthwhile to
know what the prevalence of seronegative celiac disease or pre-celiac disease
could be in these individuals.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Please review this paper.
user
Reviewer's report
Title:Increasing prevalence and high Incidence of celiac disease in elderly
people: A population-based study
Version: 1Date:2 March 2009
Reviewer: joseph murray
Reviewer's report:
This is a very important observation of the new development celiac disease in
older patients. it is of scientific and practical clinical importance.
Whilst there were new 5 elderly individuals identified with probable new onset
celiac disease, this is a small number whilst this is statistically significant in terms
of a change over prior. Could this change be due to variability in the testing
between the two time periods? This could be addressed by examining and
reporting the absolute values and arbitrary assay units between the two time
points. For example, were the earlier samples close to the threshold considered
abnormal for tissue transglutaminase antibody ? Repeating testing on both the
first and the subsequent sample at the same time for both tests to make sure this
truly was not simply variation around a threshold. The second issue is whether
there were any confounders occurring on the first time, such as the use of
steroids, be it topical or other immune modifiers.
2. Another second issue relates to the very high incidence of celiac disease in
this unique population. Is the population of Lahti particularly inbred or isolated? Is
there an especially high prevalence of homozygocity for DQ2, for example?
3. How would these results from this very isolated population relate to other
populations? Have the authors taken into account the possibilities that the
patients may have originally been seronegative celiac disease who then became
seropositive, but had celiac disease all along? Demonstration of the actual
histology would be convincing to this reviewer. Also, it would be worthwhile to
know what the prevalence of seronegative celiac disease or pre-celiac disease
could be in these individuals.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
assistant