Increase in incidence and prevalence of inflammatory bowel disease in northern Denmark: a population-based study, 1978-2002

OBJECTIVES: Although incidence rates of inflammatory bowel disease have been reported worldwide, few long-term population-based studies with current time-trend analyses exist. We therefore examined time trends in the incidence rate of inflammatory bowel disease in a 25-year study period, and estimated the prevalence in 2002. All patients diagnosed between 1978 and 2002 were included as incident cases (n=2,326) and all patients living in North Jutland County on 31 December 2002 were used to estimate prevalent cases (n=2,205). METHODS: Medical records of all patients diagnosed with ulcerative colitis and Crohn's disease in the North Jutland County Hospital Discharge Registry were reviewed to examine if the diagnostic criteria were fulfilled. Age-specific and gender-specific standardized incidence rates were calculated. RESULTS: For ulcerative colitis, incidence rates in women increased from 8.3 (95% confidence interval (CI): 6.7-9.9) in 1978-1982 to 17.0 (95% CI: 14.7-19.3) per 100,000 person-years in 1998-2002. The corresponding figures for men were 7.7 (95% CI: 6.1-9.3) and 16.7 (95% CI: 14.4-18.8) per 100,000 person-years. For Crohn's disease, the incidence rates in women increased from 4.1 (95% CI: 3.0-5.2) in 1978-1982 to 10.7 (95% CI: 8.8-12.5) per 100,000 person-years in 1998-2002. The corresponding figures for men were 3.2 (95% CI: 2.1-4.2) and 8.5 (95% CI: 6.9-10.2) per 100,000 person-years. The prevalence of ulcerative colitis and Crohn's disease was 294 and 151 per 100,000 inhabitants, respectively. CONCLUSIONS: A marked and parallel increase was seen in both ulcerative colitis and Crohn's disease in both genders during the last 25 years, with a corresponding high prevalence of both diseases.     

Update on the incidence and prevalence of Crohn's disease and ulcerative colitis in Olmsted County, Minnesota, 1940-2000

BACKGROUND: We previously reported that the prevalence of Crohn's disease (CD) and ulcerative colitis (UC) in Olmsted County, Minnesota, had risen significantly between 1940 and 1993. We sought to update the incidence and prevalence of these conditions in our region through 2000. METHODS: The Rochester Epidemiology Project allows population-based studies of disease in county residents. CD and UC were defined by previously used criteria. County residents newly diagnosed between 1990 and 2000 were identified as incidence cases, and persons with these conditions alive and residing in the county on January 1, 2001, were identified as prevalence cases. All rates were adjusted to 2000 US Census figures for whites. RESULTS: In 1990-2000 the adjusted annual incidence rates for UC and CD were 8.8 cases per 100,000 (95% confidence interval [CI], 7.2-10.5) and 7.9 per 100,000 (95% CI, 6.3-9.5), respectively, not significantly different from rates observed in 1970-1979. On January 1, 2001, there were 220 residents with CD, for an adjusted prevalence of 174 per 100,000 (95% CI, 151-197), and 269 residents with UC, for an adjusted prevalence of 214 per 100,000 (95% CI, 188-240). CONCLUSION: Although incidence rates of CD and UC increased after 1940, they have remained stable over the past 30 years. Since 1991 the prevalence of UC decreased by 7%, and the prevalence of CD increased about 31%. Extrapolating these figures to US Census data, there were approximately 1.1 million people with inflammatory bowel disease in the US in 2000.     

Systemic sclerosis in northwestern Spain: a 19-year epidemiologic study

To investigate the epidemiology of systemic sclerosis (SSc) in southern Europe, we assessed the incidence, prevalence, clinical spectrum, and survival of patients diagnosed with SSc in the Lugo region of northwestern Spain. Between January 1988 and December 2006, SSc was diagnosed in 78 Lugo residents according to the criteria proposed by LeRoy and Medsger and/or the 1980 American College of Rheumatology (ACR) preliminary criteria for the classification of SSc. However, only 44 (56.4%) of the 78 patients fulfilled the 1980 ACR criteria for the classification of SSc. The mean age at the time of disease diagnosis was 59.8 +/- 13.3 years. Twenty-three (29.5%) met definitions for diffuse SSc (dSSc), and 55 (70.5%) for limited SSc (lSSc). Patients with lSSc had a longer disease duration before the diagnosis (10.2 +/- 12.0 yr) than those with dSSc (3.7 +/- 3.2yr) (p < 0.001). Based on the criteria proposed by LeRoy and Medsger and/or the 1980 ACR criteria for the classification of SSc, the overall age- and sex-adjusted annual incidence rate over the 19-year study period was 2.3 (95% confidence interval [CI], 1.6-2.5) per 100,000 population aged 15 yr and older (women: 3.5 [95% CI, 2.3-3.9]; men: 1.0 [95% CI, 0.5-1.4]; p < 0.001). Using only the 1980 ACR criteria for SSc, the total annual-adjusted incidence rate was 1.2 (95% CI, 0.9-1.6) per 100,000 population aged 15 years and older (women: 1.8 [95% CI, 1.2-2.5]; men: 0.7 [95% CI, 0.3-1.2]; p < 0.001). The incidence increased significantly in individuals aged 45 years or older. The overall incidence rates of SSc increased over the length of the study (p for trend in the total incidence < 0.001). This was mainly due to a progressive increase of SSc in women between 1993 and 2002. By December 31, 2006, the overall age-adjusted SSc prevalence in the Lugo region of patients who met the criteria proposed by LeRoy and Medsger and/or the 1980 ACR criteria was 27.7 (95% CI, 21.1-35.84) per 100,000 population aged 15 years and older. Cardiopulmonary complications were the leading cause of death (13 of 20 cases). Compared with that in the general population, the probability of survival in patients with SSc was significantly reduced (p < 0.001).The current study establishes a baseline estimate of the incidence and clinical spectrum of SSc in northwestern Spain. According to our results, the incidence and prevalence of SSc in northwestern Spain are similar to those found in Greece and some regions of the United States. Our data confirm a reduced probability of survival in patients with SSc.     

Incidence of systemic lupus erythematosus in the United Kingdom, 1990-1999

OBJECTIVE: To estimate the annual incidence of systemic lupus erythematosus (SLE) over a 10-year period in the UK, and to examine age-, sex-, and region-specific rates. METHODS: The study was based on the UK General Practice Research Database (GPRD), which covers approximately 5% of the UK population. We estimated SLE incidence rates, during the period 1990-1999, among persons registered with practices contributing to the GPRD, representing >33 million person-years of observation. RESULTS: A total of 1,638 patients with incident SLE (1,374 females, 264 males) were identified. The age-standardized SLE incidence in the UK during the 1990s was 7.89 per 100,000 (95% confidence interval [95% CI] 7.46, 8.31) for females and 1.53 per 100,000 (95% CI 1.34, 1.71) for males (overall female-to-male ratio 5.2:1). Peak incidence occurred at age 50-54 years for females and 70-74 years for males. There was a small but insignificant increase of SLE incidence over the 10 years among females but not males. No clear association between latitude and SLE incidence was found, but regional variations existed, with age-standardized rates ranging from 3.56 per 100,000 (95% CI 3.00, 4.13) for the West Midlands to 7.62 per 100,000 (95% CI 5.59, 9.65) for Northern Ireland. CONCLUSION: This study provides updated estimates of SLE incidence in the UK. Standard methodology throughout the study period and target population allowed for comparison of rates over time and across regions.     

The prevalence and incidence of biopsy-proven lupus nephritis in the UK: Evidence of an ethnic gradient

OBJECTIVE: Renal involvement is a major complication of systemic lupus erythematosus (SLE) and is a strong determinant of morbidity and mortality. There have been no previous studies of the epidemiology of lupus nephritis. Our aim was to establish the prevalence and incidence of biopsy-proven lupus nephritis in the northwest of England in 2001 and to examine the influence of age, sex, and ethnicity. METHODS: Adults (age 18 years and older) with biopsy-proven lupus nephritis were identified from 5 sources: renal biopsy databases, dialysis/transplant databases, nephrologists' patients, clinic lists, and lupus patient groups. The denominator data for the northwest of England were ascertained from the 2001 census. RESULTS: We identified 208 cases of biopsy-proven lupus nephritis (176 women, 32 men): the overall prevalence was 4.4 per 100,000 population (95% confidence interval [95% CI] 3.8-5.0), 7.1 per 100,000 (95% CI 6.1-8.2) in women, and 1.4 per 100,000 (95% CI 1.0-2.0) in men. The prevalence was significantly higher among women in the ethnic subgroups: 110.3 per 100,000 population (95% CI 55.0-197.3) in Chinese patients, 99.2 per 100,000 (95% CI 55.5-163.6) in Afro-Caribbean, 21.4 per 100,000 (95% CI 12.0-35.2) in Indo-Asian (Asians from the Indian subcontinent), and 5.6 per 100,000 (95% CI 4.7-6.7) in white patients. The overall annual incidence rate was 0.40 per 100,000 population per year (95% CI 0.24-0.63), with a rate of 0.68 (95% CI 0.40-1.10) in women and 0.09 (95% CI 0.01-0.32) in men. Capture-recapture methods did not suggest any additional cases. CONCLUSION: This first estimate of the prevalence and incidence of biopsy-proven lupus nephritis demonstrates dramatic differences in prevalence according to ethnicity, with an increasing gradient from the white to the Indo-Asian, Afro-Caribbean, and Chinese populations.     

Epidemiology of inflammatory bowel disease in the Songpa-Kangdong district, Seoul, Korea, 1986-2005: a KASID study

BACKGROUND: Crohn's disease (CD) and ulcerative colitis (UC) are considered rare diseases in developing countries. We have evaluated the incidence and prevalence of CD and UC over time in a district of Seoul, Korea. METHODS: A population-based study was performed from 1986 to 2005 in the Songpa-Kangdong district of Seoul. To recruit patients as completely as possible, multiple information sources, including all medical facilities in the study area and 3 referral centers nearby but outside the study area, were used. RESULTS: During the 20-year study period, 138 incident cases of CD (102 men, 36 women) and 341 incident cases of UC (170 men, 171 women) were identified. For the 20-year period, the adjusted mean annual incidence rates of CD and UC per 100,000 inhabitants were 0.53 (95% CI 0.44-0.62) and 1.51 (95% CI 1.34-1.67), respectively. When analyzed by 5-year intervals, the mean annual incidence rates of CD and UC increased significantly, from 0.05 and 0.34 per 100,000 inhabitants, respectively, in 1986-1990 to 1.34 and 3.08 per 100,000 inhabitants, respectively, in 2001-2005. The adjusted prevalence rates of CD and UC per 100,000 inhabitants on December 31, 2005, were 11.24 (95% CI 9.29-13.18) and 30.87 (95% CI 27.47-34.27), respectively. CONCLUSIONS: The incidence and prevalence of CD and UC in Seoul, Korea, are still low compared with those in Western countries, but are rapidly increasing.     

Reappraisal of the epidemiology of giant cell arteritis in Olmsted County, Minnesota, over a fifty-year period

OBJECTIVE: To investigate time trends in the incidence and survival of giant cell arteritis (GCA) over a 50-year period in Olmsted County, Minnesota. METHODS: Using the unified record system at the Mayo Clinic, we identified all incident cases of GCA first diagnosed between 1950 and 1999. Incidence rates were estimated and adjusted to the 1980 United States white population for age and sex. The annual incidence rates were graphically illustrated using a 3-year centered moving average. Survival rates were computed and compared with the expected rates in the population. RESULTS: There were 173 incident cases of GCA during the 50-year study period. Of these, 79% were women and the mean age at diagnosis was 74.8 years. The overall age- and sex-adjusted incidence per 100,000 persons 50 years of age or older was 18.8 (95% confidence interval [95% CI] 15.9-21.6). Incidence was higher in women (24.4; 95% CI 20.3-28.6) than in men (10.3; 95% CI 6.9-13.6). Incidence rates increased significantly over the study period (P = 0.017); in particular, a progressive increase was observed from 1950 to 1979; subsequently, no substantial increases in incidence rates were observed. A cyclic pattern of annual incidence rates was apparent, with evidence of 6 peak periods. Survival among individuals with GCA was not significantly different from that expected in the population (P = 0.80). CONCLUSIONS: The incidence of GCA increased over the first 3 decades of the study, then remained stable over the last 20 years. The previously observed cyclic pattern of annual incidence rates was still apparent over a 50-year period. Overall survival in GCA was similar to that in the population.     

Systemic lupus erythematosus in northwestern Spain: a 20-year epidemiologic study

To further investigate the epidemiology of systemic lupus erythematosus (SLE) in southern Europe, we assessed the incidence, prevalence, clinical spectrum of the disease, flares, and survival of patients diagnosed with SLE in the Lugo region of northwestern Spain. Between January 1987 and December 2006, 150 Lugo residents were diagnosed as having SLE according to the 1982 American College of Rheumatology criteria for the classification of SLE. Women outnumbered men (127 [84.7%] vs. 23 [15.3%]). The mean age at the time of disease diagnosis was 46.1 ± 19.6 years. The mean follow-up from the time of disease diagnosis was 7.8 ± 4.5 years. The age- and sex-adjusted annual incidence rate over the 20-year study period was 3.6 (95% confidence interval [CI], 3.0-4.2) per 100,000 population aged 15 years and older. The overall annual incidence rate over the 20-year study period in women (5.9/100,000 population aged ≥ 15 yr; 95% CI, 4.9-7.0) was higher than in men (1.1/100,000 population aged ≥ 15 yr; 95% CI, 0.7-1.7) (p < 0.001). By December 31, 2006, the overall age-adjusted SLE prevalence in the Lugo region for patients who fulfilled at least 4 of 1982 American College of Rheumatology criteria was 17.5 per 100,000 population aged 15 years and older (95% CI, 12.6-24.1). Prevalence in women (29.2/100,000 population aged ≥ 15 yr; 95% CI, 20.0-40.7) was higher than in men (5.8/100,000 population aged ≥ 15 yr; 95% CI, 2.0-12.0). The most frequent clinical manifestation was arthritis. As reported in population-based studies on SLE patients of European descent, renal disease was observed in only 27.3% of the patients. The rate of flares was 0.084/year. A younger age and the presence of nephritis at the time of disease diagnosis were associated with the development of flares during the follow-up of Lugo patients. Compared with the general population the probability of survival in patients with SLE was significantly reduced (p = 0.04). In conclusion, the present study establishes a baseline estimate of the incidence and clinical spectrum of SLE in northwestern Spain. According to our results, the incidence of SLE in northwestern Spain is slightly higher than that reported in most European regions. Patients with SLE from northwestern Spain have a later average age onset and a lower frequency of nephritis than in the African-American population. However, our data show a reduced probability of survival in Spanish patients with SLE.     

Trends in incidence and clinical presentation of temporal arteritis in Olmsted County, Minnesota, 1950-1985

Ninety-four Olmsted County, Minnesota residents with temporal arteritis (TA) initially diagnosed between 1950 and 1985 (incidence cohort) were identified. The age- and sex-adjusted incidence of TA per 100,000 population age 50 years or older was 17.0 (95% confidence interval [CI] 13.6-20.5), with a marked increase in incidence with age and a threefold greater incidence in women (23.4, 95% CI 18.2-28.7) than in men (7.4, 95% CI 3.7-11.0). The previously described secular increase in TA incidence in Olmsted County women continued from 1970 through 1985, while TA incidence in men declined in this latter time period. Although the frequency of classic clinical manifestations of TA declined over time, the percentage of patients undergoing biopsy who have positive specimens remained relatively constant (women 41%, men 26%). The incidence rate of temporal artery biopsy also increased for women during this period, but declined for men, suggesting that the differing trends in TA incidence by sex may be partially attributable to a detection bias. Future research in TA etiology and epidemiology should focus on possible causal factors linked to the differential TA incidence by sex.     

Trends in incidence and mortality in rheumatoid arthritis in Rochester, Minnesota, over a forty-year period

OBJECTIVE: To determine time trends in the epidemiology of rheumatoid arthritis (RA) in a population-based cohort. METHODS: An inception cohort of residents of Rochester, Minnesota > or = 18 years of age who first fulfilled the American College of Rheumatology 1987 criteria between January 1, 1955 and December 31, 1994 (applied retrospectively, as appropriate) was assembled and followed up until January 1, 2000. Incidence rates were estimated and were age- and sex-adjusted to the 1990 white population of the US. A birth cohort analysis was performed, and survival rates over time were examined. RESULTS: The incidence cohort comprised 609 patients, 445 (73.1%) of whom were female and 164 (26.9%) were male, with a mean age at incidence of 58.0 years. The overall age- and sex-adjusted annual incidence of RA among Rochester, Minnesota, residents > or = 18 years of age was 44.6/100,000 population (95% confidence interval 41.0-48.2). While the incidence rate fell progressively over the 4 decades of study, from 61.2/100,000 in 1955-1964, to 32.7/100,000 in 1985-1994, there were indications of cyclical trends over time. Birth cohort analysis showed diminishing incidence rates through successive cohorts following a peak in the 1880-1890 cohorts. Incidence rates increased with age until age 85, but peaked earlier in women than in men. The survival rate in RA patients was significantly lower than the expected rate in the general population (P < 0.001), and no improvement was noted over time. CONCLUSION: The secular trends demonstrated in this study population, including the progressive decline in the incidence of RA over the last 40 years, suggest that an environmental factor may play a role in the etiology of RA.     

Epidemiology of polymyalgia rheumatica in olmsted county,minnesota, 1970–1991

Objective. To determine the incidence, prevalence, and survival of polymyalgia rheumatica (PMR) over a 22-year period in Olmsted County, Minnesota. Methods. Using the unified record system at the Mayo Clinic for the Olmsted County population, we reviewed all medical records with a diagnosis of PMR from 1970 through 1991. Results. There were 245 (173 female; 72 male) incidence cases of PMR between 1970 and 1991. The average annual age- and sex-adjusted incidence of PMR per 100,000 population ≥ 50 years was 52.5 (95% confidence interval [CI] 45.9–59.2), with a significantly higher incidence in females (61.7; 95% CI 52.3–71.2) than in males (39.9; 95% CI 30.7–49.2). The incidence varied over the period of observation, but no significant trends were found. The prevalence of PMR among persons ≥ 50 years on January 1, 1992 was 6/1,000. There was a small but significantly increased survival rate among male PMR patients compared with the general population. Conclusion. Our data demonstrate that PMR is a common nonfatal disease in the elderly, the incidence and clinical manifestations of which have varied but remained relatively stable over the last 2 decades.     

Giant cell arteritis in northwestern Spain: a 25-year epidemiologic study

To continue our investigation of the epidemiology of giant cell arteritis (GCA) in southern Europe, we assessed the potential presence of trends, peaks, and fluctuations in the incidence of this vasculitis over a 25-year period in the Lugo region of northwestern Spain. We also sought to determine whether changes in the clinical spectrum of the disease existed. From 1981 to 2005, biopsy-proven GCA was diagnosed in 255 Lugo residents. The age- and sex-adjusted annual incidence rate was 10.13 (95% confidence interval [CI], 8.93-11.46) per 100,000 population aged 50 years and older. The mean age +/- SD at the time of diagnosis was 75.0 +/- 6.9 years. The annual incidence rate in women (10.23; 95% CI, 8.60-12.08) was slightly greater than that in men (9.92; 95% CI, 8.19-11.89) (p = 0.15). The annual incidence rate increased with advancing age up to a maximum of 23.16 (95% CI, 19.52-27.28) in the 70-79 year age-group. A progressive increase in the incidence was observed from 1981 through 2000 (p = 0.001). However, the age- and sex-adjusted incidence rate for biopsy-proven GCA in the Lugo region did not show peaks in the annual incidence of GCA. Likewise, we observed no seasonal pattern for the diagnosis of the disease. Visual ischemic manifestations and irreversible visual loss were observed in 57 (22.4%) and 32 (12.5%) of the 255 patients, respectively. A negative trend manifested by a progressive decline in the number of patients with visual ischemic manifestations (p = 0.021) or permanent visual loss (p = 0.018) was found over the 25-year period of study. The decline in the frequency of visual manifestations of GCA could not be attributed to a shorter delay to diagnosis, as no significant differences were observed when the delays to diagnosis in the 5 consecutive 5-year periods were compared. In conclusion, the current study confirms a progressive increase in the incidence of biopsy-proven GCA in northwestern Spain, and suggests that there has been a change in the clinical spectrum of the disease.     

Secular Trends in Incidence and 30-Day Case Fatality of Acute Pancreatitis in North Jutland County,Denmark: A Register-based Study from 1981-2000

Background: The incidence rate of acute pancreatitis has been reported as having increased during recent decades in Western countries. Reported mortality lies around 10% and has improved during the past 20 years. The incidence rate and 30-day case fatality rate of acute pancreatitis in North Jutland County, Denmark were examined for the period 1981 to 2000. Methods: Data were collected from the Hospital Discharge Registry of North Jutland County for the period 1981-2000. Sex- and age-standardized incidence rates and 30-day case fatality rate of a first attack of acute pancreatitis were calculated. Data on endoscopic procedures were assessed for the period 1992 to 2000 and on certain drugs for 1991 to 1999. Results: The incidence rate of acute pancreatitis in women increased from 17.1 per 100,000 person-years in 1981 (95% confidence interval (CI), 12.6-23.2) to 37.8 per 100,000 person-years in 2000 (95% CI, 31.0-46.1). The corresponding increase in men was from 18 per 100,000 person-years in 1981 (95% CI, 13.3-24.2) to 27.1 per 100,000 person-years in 2000 (95% CI, 21.5-34.3). The incidence rate of acute pancreatitis increased with age in both sexes. The overall 30-day case fatality rate was 7.5% (95% CI, 6.5-8.7) increasing with age, adjusted odds ratio (OR) = 6.4 (95% CI, 3.5-11.6) and decreased with time, adjusted OR = 0.7 (95% CI, 0.4-1.0). Conclusion: The incidence of acute pancreatitis has increased, and in women surpassed that in men in 1999 and 2000. Short-term prognosis has improved.     

Secular trends in incidence and 30-day case fatality of acute pancreatitis in North Jutland County,Denmark: a register-based study from 1981-2000

BACKGROUND: The incidence rate of acute pancreatitis has been reported as having increased during recent decades in Western countries. Reported mortality lies around 10% and has improved during the past 20 years. The incidence rate and 30-day case fatality rate of acute pancreatitis in North Jutland County, Denmark were examined for the period 1981 to 2000. METHODS: Data were collected from the Hospital Discharge Registry of North Jutland County for the period 1981-2000. Sex- and age-standardized incidence rates and 30-day case fatality rate of a first attack of acute pancreatitis were calculated. Data on endoscopic procedures were assessed for the period 1992 to 2000 and on certain drugs for 1991 to 1999. RESULTS: The incidence rate of acute pancreatitis in women increased from 17.1 per 100,000 person-years in 1981 (95% confidence interval (CI), 12.6-23.2) to 37.8 per 100,000 person-years in 2000 (95% CI, 31.0-46.1). The corresponding increase in men was from 18 per 100,000 person-years in 1981 (95% CI, 13.3-24.2) to 27.1 per 100,000 person-years in 2000 (95% CI, 21.5-34.3). The incidence rate of acute pancreatitis increased with age in both sexes. The overall 30-day case fatality rate was 7.5% (95% CI, 6.5-8.7) increasing with age, adjusted odds ratio (OR) = 6.4 (95% CI, 3.5-11.6) and decreased with time, adjusted OR = 0.7 (95% CI, 0.4-1.0). CONCLUSION: The incidence of acute pancreatitis has increased, and in women surpassed that in men in 1999 and 2000. Short-term prognosis has improved.     

Incidence and prevalence of large vessel vasculitis (giant cell arteritis and Takayasu arteritis) in northern Italy: A population-based study

ObjectivesTo investigate the epidemiology of the entire spectrum of large vessel vasculitis (LVV) in a well-defined population from a Northern Italian area.MethodsAll patients with incident giant cell arteritis (GCA) diagnosed from 2005 to 2016 and all patients with incident Takayasu arteritis (TAK) diagnosed from 1998 to 2016 living in the Reggio Emilia area were identified. Only patients satisfying the modified inclusion criteria of the GiACTA trial, and the 1990 ACR classification criteria for TAK were included. The epidemiology of cranial- and LV-GCA was separately evaluated.Results207 patients were diagnosed with GCA and 5 with TAK. 123 patients had cranial-GCA, 53 patients had LV-GCA, and the remaining 31 patients had overlapping features. The standardized annual incidence rate of GCA was 8.3 (95% CI 7.1, 9.4) per 100,000 population ages ≥50 years. The standardized annual incidence rate of cranial-GCA (6.1 [95% CI 5.1, 7.1] per 100,000 population ages ≥50 years) was double the rate of LV-GCA (3.4 [95% CI 2.7, 4.2]). The age-specific incidence rates were similar in the <70 and >90 years age groups, but they were higher in cranial-GCA than in LV-GCA in the age groups 70–79 and 80–89 years. The age- and sex-adjusted annual incidence rate of TAK was 0.5 (95% CI 0.1, 1.2) per 1,000,000 population.ConclusionIncidence of GCA is higher than previously reported by study evaluating only biopsy-proven or ACR classification criteria confirmed cases. Cranial-GCA and LV-GCA have epidemiological differences. TAK is an extremely rare disease also in Italy.     

Prevalence and incidence in patients with autoimmune rheumatic diseases: A nationwide population‐based study in Taiwan

Objective

The purpose of this study was to determine the prevalence, incidence, and mortality rates of autoimmune rheumatic diseases (ARDs) by using a population‐based database.

Methods

We used the longitudinal health insurance database (comprising 1,000,000 beneficiaries) of the Taiwan National Health Insurance from 2000 to 2008 and the National Death Registry of Taiwan from 2000 to 2008.

Results

The overall prevalence of major ARDs was 101.3 (95% confidence interval [95% CI] 27.5–107.9) per 100,000 populations; the prevalence was 165.1 (95% CI 44.8–177.1) in women and 40.1 (95% CI 10.9–46.1) in men. The prevalences of rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sjögren's syndrome, progressive systemic sclerosis, polymyositis/dermatomyositis, vasculitis, and Behçet's disease were 52.4 (95% CI 14.2–57.2), 37.0 (95% CI 10.0–41.0), 16.0 (95% CI 4.3–18.7), 3.8 (95% CI 1.0–5.3), 2.9 (95% CI 0.8–4.2), 5.7 (95% CI 1.6–7.4), and 1.4 (95% CI 0.4–2.3) per 100,000 persons, respectively. Between 2001 and 2008, the incidence rates (per 100,000 person‐years) for these diseases were 17.3, 8.4, 10.6, 1.5, 1.5, 1.2, and 0.8, respectively. The incident cases with ARDs had a higher risk of mortality, with the standardized mortality ratio (SMR) ranging from 1.3 to 3.7.

Conclusion

In 2000, the prevalence of major ARDs was 1.4–52.4 per 100,000 persons in Taiwan. Between 2000 and 2008, the incidence rates of various ARDs were 0.8–17.3 per 100,000 person‐years. The prevalence and incidence of RA were the highest, followed by SLE and Sjögren's syndrome, and those of Behçet's disease were the lowest. Patients with different types of ARDs had higher mortality and SMR than those of the general population.     

Epidemiology of idiopathic dilated and hypertrophic cardiomyopathy. A population-based study in Olmsted County, Minnesota, 1975-1984

Using the records linkage system of the Mayo Clinic and of the Rochester Epidemiology Project, which accesses diagnostic data on the entire population of Olmsted County, Minnesota, we identified 45 new cases of idiopathic dilated cardiomyopathy (DCM) and 19 new cases of hypertrophic cardiomyopathy (HCM) among county residents for the years 1975-1984. Overall age- and sex-adjusted incidence rates were 6.0/100,000 and 2.5/100,000 person-years, respectively. The incidence of DCM doubled from 3.9/100,000 in the first 5 years to 7.9/100,000 person-years in the last 5 years of study. The corresponding change for HCM was from 1.4 to 3.6/100,000 person-years. Age- and sex-adjusted prevalence rates as of January 1, 1985, for DCM and HCM were 36.5/100,000 and 19.7/100,000 population, respectively. The prevalence of DCM in persons less than 55 years old was 17.9/100,000, over a third of whom were New York Heart Association functional Class III or IV at diagnosis. These estimates may be of value in determining the potential use of health care resources, particularly cardiac transplantation.     

Epidemiology of Celiac Sprue: A Community-based Study

Objective: To address the frequency and outcome of celiac disease in a United States community. Methods: We identified all Olmsted County, Minnesota, residents diagnosed with this condition during the period, 1960 through 1990, using the resources of the Rochester Epidemiology Project. Twenty-eight incident cases (19 women, nine men) were identified. Results: The overall age- and gender-adjusted incidence of celiac disease in the community was 1.2 per 100,000 person-yr (95% CI 0.7,1.6). There were no significant changes in incidence over time, although rates did increase; the incidence was similar in men and women and rose with age in both genders ( p < 0.05). Survival in this inception cohort was 100% at 6 months and 96% at 5 yr, which was not significantly different from expected. The estimated prevalence on January 1, 1991, was 21.8 per 100,000. Conclusion: This study provides the first epi-demiologic data on celiac disease in the United States.     

Trends in the identification and clinical features of celiac disease in a North American community, 1950-2001.

BACKGROUND AND AIMS: Celiac disease is considered rare in North America. However, an increasing incidence and widening clinical spectrum have been reported in many countries, and serologic screening suggests a higher prevalence of minimally symptomatic disease. This study reports temporal trends in the incidence of celiac disease in Olmsted County, Minnesota. METHODS: All county residents diagnosed with celiac disease between 1950 and 2001 were identified through the Rochester Epidemiology Project. Incidence rates were calculated assuming a Poisson distribution, and changes in incidence by calendar year, age, and gender were assessed by using Poisson regression. RESULTS: Altogether, 82 new cases of celiac disease were identified during the 50-year period. There was a marked female predominance (P < 0.005), and the incidence rates increased with age (P < 0.001) and calendar period (P < 0.001). The overall annual incidence of celiac disease was 2.1 per 100,000 (95% confidence interval [CI], 1.7-2.6) but increased from 0.9 per 100,000 (CI, 0.5-1.2) in 1950-1989 to 3.3 per 100,000 (95% CI, 2.2-4.4) in the 1990s. The incidence was 9.1 per 100,000 (95% CI, 5.2-13.0) in the final 2 years of the study. Serology prompted biopsy in a substantial proportion of recent diagnoses. Clinical features also changed over time, with less diarrhea and weight loss at presentation. CONCLUSIONS: Celiac disease has increased recently in this well-characterized population. Milder clinical features and use of serology suggest an increased detection rate, although a true increase in incidence may have also occurred. Celiac disease is not rare in North America.