Abstract
Aims: The reason why some of the patients with initially diagnosed coeliac disease (CD) according to the first 3 criteria of ESPGAN do not react with mucosal damage after gluten challenge remains unclear. We investigated whether genetic variances on their HLA-DR phenotypes could account for the different course of the disease. Methods: 61 children with CD were typed for their HLA-DR phenotypes according to standard techniques. 45 of the CD patients were true coeliacs according to the 4 criteria of ESPGAN. In contract 16 showed no mucosal relapse after prospective gluten ghallenge. 76 normal subjects from the area served as controls. Statistical analysis with two tailed p-value was calculated using Fisher's chi-square test after Yates correction. Results: Conclusion: HLA-DR phenotypes in hildren with ‘true’ CD show significantly higher proportions of DR 5/DR 7 or DR3/DR 7 than those with ‘transient’ CD. We speculate that mucosal reactions to gluten by later challenges might depend upon the HLA-DR phenotype of the host. Thus HLA-typing might even be of predictive value in CD.
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