Shilpy Singla1, Praveen Kumar2, Preeti Singh1, Gurvinder Kaur3, Anurag Rohtagi4, Monisha Choudhury5. 1. Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, 110001, India. 2. Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, 110001, India. kumardrpraveen@rediffmail.com. 3. Department of Transplant Immunology & Immunogenetics, All India Institute of Medical Sciences, New Delhi, India. 4. Department of Medicine, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India. 5. Department of Pathology, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India.
Abstract
OBJECTIVE: To study the prevalence of Celiac disease (CD) in first-degree relatives (FDR) of CD children. METHODS: This observational study was performed in FDR (parents and siblings) of consecutive newly diagnosed cases of CD enrolled from January 2011 through March 2012. Screening for CD in FDR was done using IgA tissue transglutaminase (tTG) levels in serum and the seropositive subset underwent upper gastrointestinal (UGI) endoscopy and biopsy to confirm the disease. In addition, HLA analysis for CD was performed in most of the index cases and FDR. RESULTS: Of 202 FDR of the 64 index cases with CD, 17.3 % (35/202) were seropositive for IgA tTG while confirmed biopsy proven CD was diagnosed in 10.2 % (8/78) of children and 8.1 % (10/124) of adults. HLA DQ2/DQ8 was positive in 96.7 % of the index cases and all FDR with confirmed CD. CONCLUSIONS: The prevalence of CD among FDR is 9 fold higher than the general population. High prevalence of CD in presence of anemia and short stature in seropositive FDR in index study indicates need of targeted screening of this subgroup for the presence of CD.CD is unlikely in the absence of HLADQ2/DQ8.
OBJECTIVE: To study the prevalence of Celiac disease (CD) in first-degree relatives (FDR) of CDchildren. METHODS: This observational study was performed in FDR (parents and siblings) of consecutive newly diagnosed cases of CD enrolled from January 2011 through March 2012. Screening for CD in FDR was done using IgA tissue transglutaminase (tTG) levels in serum and the seropositive subset underwent upper gastrointestinal (UGI) endoscopy and biopsy to confirm the disease. In addition, HLA analysis for CD was performed in most of the index cases and FDR. RESULTS: Of 202 FDR of the 64 index cases with CD, 17.3 % (35/202) were seropositive for IgA tTG while confirmed biopsy proven CD was diagnosed in 10.2 % (8/78) of children and 8.1 % (10/124) of adults. HLA DQ2/DQ8 was positive in 96.7 % of the index cases and all FDR with confirmed CD. CONCLUSIONS: The prevalence of CD among FDR is 9 fold higher than the general population. High prevalence of CD in presence of anemia and short stature in seropositive FDR in index study indicates need of targeted screening of this subgroup for the presence of CD.CD is unlikely in the absence of HLADQ2/DQ8.
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