PREVALENCE OF CELIAC DISEASE AMONG FIRST DEGREE RELATIVES IN THE U.S.A.

Abstract

54 Aim. Celiac disease (CD) is still considered rare in the United States although our blood donor screening (Gastroenterology 1996; 110: A351) study suggested a similar prevalence of this disease in US than in Europe. Because there is no data available about the prevalence of CD among the first degree relatives of celiac patients in U.S. our aim was to establish the prevalence of CD in the first degree relatives of patients living in the Baltimore and New York areas. Methods. First degree relatives of the CD patients were recruited by the local support groups. Informed consent was obtained from 220 first degree relatives and a questionnaire was used to collect demographic and medical history data. 2 cc blood was obtained from each participants for antiendomysium (EmA) IgA and antigliadin IgA & IgG antibodies. Subjects with positive EmA serologies were undergone endoscopy with biopsies. Results. The age of participants varied between 2 and 78. All of them were Caucasian in origin and claimed to be asymptomatic. They were classified into three groups. TableConclusion. 44 (20%) of first degree relatives had elevation in antigliadin antibodies and 10 of them (22.7%) had positive EmA test. The presence of celiac mucosal lesion was confirmed in 8 EmA positive asymptomatic subjects. Biopsies in two EmA positive relatives and tests for total IgA levels are pending. These data indicates that the prevalence of CD in the first degree relatives is at least 3.63%. This prevalence value is apparently lower than those reported in Europe. The possible explanations are a lower gluten ingestion, the diagnosis of CD is not biopsy confirmed in each patient and the presence of unknown protective factors in the U.S.A.