Relatives Of Celiac Patients Research Articles

Clinical manifestations of celiac disease: towards early diagnosis

Celiac disease is characterized by significant clinical polymorphism, which makes it difficult to diagnose and postpones the start of pathogenetic treatment, ultimately worsening the prognosis of the disease. In this regard, knowledge of the clinical features and variants of the disease is of paramount importance for an effective diagnostic process. The article discusses various options for the clinical manifestations of celiac disease. The possibility of celiac disease should be borne in mind in patients with: 1. a history and clinical manifestations characteristic of celiac disease; 2. symptoms of celiac disease associated diseases; 3. symptoms that may be a manifestation of atypical celiac disease. Relatives of celiac patients are also at risk. Overweight and constipation do not reject the diagnosis of celiac disease. Taking into account all these circumstances will make it possible to diagnose and begin treatment in a timely manner, reasonably counting on its maximum effectiveness

Lack of long-term follow-up after paediatric-adult transition in coeliac disease is not associated with complications, ongoing symptoms or dietary adherence.

Follow-up of coeliac disease is recommended to prevent complications associated with unsuccessful treatment. The objective of this article is to evaluate the implementation and significance of long-term follow-up. Medical data were collected from 585 and follow-up questionnaires sent to 559 current adult coeliac disease patients diagnosed in childhood. Diagnostic features and adulthood health outcomes were compared between those with and without adulthood follow-up. Of paediatric patients, 92% were followed up 6-24 months after diagnosis. A total of 235 adults responded to the questionnaires a median of 18 years after diagnosis, and 25% of them reported regular follow-up. They were diagnosed more recently than those without follow-up (median year 2001 vs 1995, p = 0.001), being otherwise comparable at diagnosis. Those with follow-up were less often smokers (5% vs 16%, p = 0.042) and relatives of coeliac patients (48% vs 66%, p = 0.018), and more often students (48% vs 28%, p = 0.005) and type 1 diabetics (19% vs 4%, p = 0.001). Lack of follow-up was not associated with complications, ongoing symptoms, poorer general health or dietary adherence. All completely non-adherent patients were without follow-up. Most coeliac disease patients diagnosed in childhood were not followed up according to recommendations in adulthood. The individual effect of this on long-term treatment outcomes varied markedly.

Prevalence of Celiac Disease in Children with Type 1 Diabetes Mellitus in the South of Turkey

Background: Type 1 Diabetes Mellitus (DM), autoimmune disorders, relatives of celiac patients have higher risk of developing celiac disease (CD) because they share the same HLA type. Celiac disease and type 1 DM are autoimmune and common in children. According to international guidelines, serological screening for CD in children and adults with type 1 DM is recommended but there is no consensus on how often it will be performed. Objectives: We aimed to investigate the prevalence of CD in children with type 1 diabetes mellitus (DM). Methods: This current study was carried out between 01 March 2017 and 15 December 2018. 273 children with type 1 DM were included in the study. Tissue transglutaminase antibody IgA (tTG IgA) and total IgA levels were measured in all patients. The patients with tTG IgA positivity underwent gastroduodenoscopy. Results: Of the 273 patients (139 girls), the mean age was 11.61 ± 3.73 years. tTG IgA was positive in 23 patients, and 2 of them refused the process of endoscopy. Gastroduodenoscopy was performed on other patients. 11 patients with Marsh 3, 2 patients with Marsh 2, 4 patients with Marsh 1, and 4 patients with Marsh 0 were detected in the present study. In other words, 12 patients were diagnosed with CD. Nine of 12 patients diagnosed with CD were diagnosed within the first 5 years after the diagnosis of type 1 DM. Conclusions: We found that the prevalence of biopsy-proven CD in children with type 1 DM was 4.4%, which was approximately 9 times higher than the prevalence of CD in the general population. In the current study, 9 of 12 patients diagnosed with CD were diagnosed within the first 5 years after DM. According to our results, we recommend that screening tests for CD should be performed at least once a year for 5 years in children with Type 1 DM, even if the patients are asymptomatic.

First-degree Relatives of Celiac Patients: Are They at an Increased Risk of Developing Celiac Disease?

First-degree Relatives of Celiac Patients: Are They at an Increased Risk of Developing Celiac Disease?

Silent Celiac Disease Is Frequent in the Siblings of Newly Diagnosed Celiac Patients

Background/Aims: Celiac disease is caused by environmental and genetic factors, and the relatives of celiac patients are at higher risk of developing celiac disease than the general population. This prospective study evaluates the prevalence of celiac disease in the asymptomatic siblings of celiac patients. Methods: Forty-eight siblings (22 males; mean age 13 years) of 39 celiac children (20 males; mean age 4 years), and 120 siblings (55 males; mean age 33 years) of 55 adult celiac patients (12 males; mean age 31 years) were serologically screened for celiac disease. Positive cases were considered for endoscopic duodenal biopsies. Results: Forty of the 168 asymptomatic siblings (23.8%) were affected by celiac disease. There were no differences between the index cases with and without affected siblings in terms of age at diagnosis, symptoms at onset, order of birth, associated disorders or other affected relatives. The male siblings of pediatric patients were affected in 40.9% of cases and female siblings in 26.9%; the corresponding figures for adults were 16.4 and 23.1%. Conclusions: Silent celiac disease is 24–48 times more frequent in the siblings of celiac patients than in the general population. No predictive factors for sibling involvement were found. Adult females seem to tolerate gluten less than adult males.

Triagem sorológica de familiares de pacientes com doença celíaca: anticorpos anti-endomísio, antitransglutaminase ou ambos?

Celiac disease is the most common intestinal disorder of caucasian populations and presents a prevalence of 8% to 18% between the relatives of patients. The anti-endomysial (IgA-EmA) and anti-tissue transglutaminase antibodies (IgA-tTG) have represented an important non invasive and sensitivity method of screening and diagnosis of celiac disease in risk groups and populations. To investigate the prevalence of IgA-EmA and IgA-tTG antibodies in relatives of celiac patients and verify the degree of concordance between them. One hundred and seventy seven relatives of celiac patients (76(feminino); 101(masculino); 2-79 years) and 93 healthy individuals were evaluated (34(feminino); 59(masculino); 2-71 years). IgA-EmA were detected by indirect immunofluorescence, with human umbilical cord as substrate, while anti-IgA-tTG titers were measured by enzyme-linked immunosorbent assay (ELISA), using commercial kit. Total positivity to antibodies in relatives of celiac patients was of 21% (37/177), and showed significant difference compared to control group (0%; 0/93). Twelve percent (21/177) of celiac disease relatives were positive to IgA-EmA, 13.56% (24/177) to IgA-tTG, and 4.52% (8/177) to both assays simultaneously. The concordance between both methods was 83.6% (148/177) and the discordance was 16.4% (29/177), with a positive and significant correlation (r = 0.435). Among the concordant results, 79.1% (140/177) were negative and 4.52% (8/177) were positive to both antibodies. Among the discordant results, 7.34% (13/177) were positive to IgA-EmA and negative to IgA-tTG, while 9.04% (16/177) were negative to IgA- EmA and positive to IgA-tTG. Although the high positivity to IgA-EmA and IgA-tTG emphasizes the importance of the serological screening in relatives of celiac patients, the discordances detected in this study showed that the use of only one method can lead to false negative results. Consequently these relatives will not be submitted to intestinal biopsy to confirm the diagnosis of celiac disease, and to the correct and earlier treatment.

High prevalence of coeliac disease among first-degree relatives of coeliac patients in Hungary

High prevalence of coeliac disease among first-degree relatives of coeliac patients in Hungary

Serological markers and HLA-DQ2 haplotype among first-degree relatives of celiac patients. Catalonian Coeliac Disease Study Group.

Serologic markers, HLA-DQ2 haplotype, and clinical features suggestive of celiac disease were studied to assess their diagnostic value in a multicentric study to detect celiac disease in 675 first-degree relatives of 227 celiac probands. Serum IgA-class anti-endomysium and IgA-class anti-gliadin antibodies were positive in 5.8% and 1.9% of relatives, respectively. HLA-DQ2 haplotype was present in 64% of relatives, and the overall rate of celiac disease diagnosed by intestinal biopsy was 5.5%. The frequency of HLA-DQ2 in the celiac patients and controls was 93% and 18%, respectively. The most frequent clinical features--diarrhea, anemia, food intolerance, and growth retardation--were not present in one third of the celiac disease relatives. We conclude that the assessment of IgA-class anti-endomysium antibodies alone seems a reasonable approach for screening celiac disease in relatives and cannot be replaced by an accurate clinical anamnesis. HLA-DQ2 haplotype may identify the population with a high genetic susceptibility to celiac disease.

Adult Celiac Disease: Report of a Case

Adult Celiac Disease: Report of a Case

Gliadin antibody test had moderate sensitivity for celiac disease in adults

DiagnosisSeptember 1, 1994Gliadin antibody test had moderate sensitivity for celiac disease in adultsJames P. Keating, MDJames P. Keating, MDSt. Louis Children's Hospital, St. Louis, Missouri, USA (J.P.K.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJC-1994-121-2-051 SectionsAboutFull Text ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookTwitterLinkedInRedditEmail Source CitationBodé S, Gudmand-Høyer E. Evaluation of the gliadin antibody test for diagnosing coeliac disease. Scand J Gastroenterol. 1994 Feb;29:148-52.References1 Knudtzon J, Fluge G, Aksnes L. Routine measurements of gluten antibodies in children of short stature. J Pediatr Gastroenterol Nutr. 1991;12:190-4. Google Scholar2 Cacciari G, Salardi S, Volta U, et al. Prevalence and characteristics of coeliac disease in type 1 diabetes mellitus. Acta Paediatr Scand. 1987;76:671-2. Google Scholar3 Corazza G, Valentini RA, Frisoni M, et al. Gliadin immune reactivity is associated with overt and latent enteropathy in relatives of celiac patients. Gastroenterology. 1992;103:1517-22. Google Scholar Author, Article, and Disclosure InformationAffiliations: St. Louis Children's Hospital, St. Louis, Missouri, USA (J.P.K.) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails September 1, 1994Volume 121, Issue 2Page: 51KeywordsAlcoholicsAtrophyBiopsyCeliac diseaseCellsChildrenChronic diarrheaChronic pancreatitisCirrhosisCrohn's diseaseDietEnzyme linked immunosorbent assayGastroenteritisGastroenterology and hepatologyIrritable bowel syndromeMorbidityPopulation statisticsSpecificityUlcerative colitis ePublished: 9 March 2020 Issue Published: September 1, 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.Loading ...

Gliadin immune reactivity is associated with overt and latent enteropathy in relatives of celiac patients

Antigliadin antibodies have been widely used in the screening of celiac disease. Using this test, candidates for jejunal biopsy were selected from 328 first-degree relatives of 128 adult celiac patients. All relatives geographically available were willing to participate in the study. Twenty-one turned out to be positive for antigliadin antibodies, and in 13 jejunal histology was consistent with celiac disease. In the remaining 8, the morphometric evaluation of jejunal biopsy specimens showed a mean surface to volume ratio that, although in the normal range, was significantly lower than that of other 10 relatives negative for antigliadin antibodies and 16 biopsied controls. It was concluded that antigliadin antibody testing is a valuable method for the screening of celiac disease among family members and that relatives with genetically predisposed gliadin sensitivity, without gross histological lesions but with minor morphometric abnormalities of the jejunal mucosa, may be regarded as subjects with latent celiac disease.