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Predictors of family risk for celiac disease: a population-based study.
Clin Gastroenterol Hepatol. 2008 Sep; 6(9):983-7.CG

Abstract

BACKGROUND & AIMS

There is an elevated prevalence of celiac disease (CD) in family members (FMs) of CD patients, but most prior studies have been done on selected populations. Our aim was to determine the clinical, serologic, and genetic predictors of CD in FMs of a population-based cohort of index cases.

METHODS

Index cases from southeast Minnesota provided contact information for their first-degree relatives. FMs were examined for endomysial antibodies (EMAs), tissue transglutaminase antibodies (tTGAs), and HLA-DQ genotyping. Two questionnaires were applied, Bowel Disease Questionnaire and Short Form Health Survey. Intestinal biopsies were offered if there were any positive autoantibody or seronegative FMs with gastrointestinal symptoms and HLA-DQ at risk for CD.

RESULTS

We recruited 111 index cases that had 579 FMs, of whom 344 (59%) were investigated. The average screening rate among families was 65%. A positive tTGA test was found in 47 (14%), 33 with a positive EMA test. CD was diagnosed in 39 (21 males), with an estimated prevalence of 11% (lambda(R) = 16.1). All affected FMs carried the at-risk genotypes. Twenty-one (54%) had "silent" disease, most with severe intestinal villous atrophy. Carrying HLA-DQ2 (odds ratio, 16.1; 95% confidence interval, 2.1-123) and being a sibling (odds ratio, 2.5; 95% confidence interval, 1.1-5.8) are high-risk factors for CD.

CONCLUSIONS

CD is more common in first-degree relatives than previously reported in the United States, with siblings having the greatest risk. There is male preponderance of new cases, and many had silent disease despite severe histologic injury. A more proactive case-finding strategy in FMs might improve the diagnostic rate of CD in North America.

Authors+Show Affiliations

Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18585974

Citation

Rubio-Tapia, Alberto, et al. "Predictors of Family Risk for Celiac Disease: a Population-based Study." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 6, no. 9, 2008, pp. 983-7.
Rubio-Tapia A, Van Dyke CT, Lahr BD, et al. Predictors of family risk for celiac disease: a population-based study. Clin Gastroenterol Hepatol. 2008;6(9):983-7.
Rubio-Tapia, A., Van Dyke, C. T., Lahr, B. D., Zinsmeister, A. R., El-Youssef, M., Moore, S. B., Bowman, M., Burgart, L. J., Melton, L. J., & Murray, J. A. (2008). Predictors of family risk for celiac disease: a population-based study. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 6(9), 983-7. https://doi.org/10.1016/j.cgh.2008.04.008
Rubio-Tapia A, et al. Predictors of Family Risk for Celiac Disease: a Population-based Study. Clin Gastroenterol Hepatol. 2008;6(9):983-7. PubMed PMID: 18585974.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of family risk for celiac disease: a population-based study. AU - Rubio-Tapia,Alberto, AU - Van Dyke,Carol T, AU - Lahr,Brian D, AU - Zinsmeister,Alan R, AU - El-Youssef,Mounif, AU - Moore,S Breanndan, AU - Bowman,Martha, AU - Burgart,Lawrence J, AU - Melton,L Joseph,3rd AU - Murray,Joseph A, Y1 - 2008/06/30/ PY - 2008/01/08/received PY - 2008/03/31/revised PY - 2008/04/03/accepted PY - 2008/7/1/pubmed PY - 2008/10/24/medline PY - 2008/7/1/entrez SP - 983 EP - 7 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin Gastroenterol Hepatol VL - 6 IS - 9 N2 - BACKGROUND & AIMS: There is an elevated prevalence of celiac disease (CD) in family members (FMs) of CD patients, but most prior studies have been done on selected populations. Our aim was to determine the clinical, serologic, and genetic predictors of CD in FMs of a population-based cohort of index cases. METHODS: Index cases from southeast Minnesota provided contact information for their first-degree relatives. FMs were examined for endomysial antibodies (EMAs), tissue transglutaminase antibodies (tTGAs), and HLA-DQ genotyping. Two questionnaires were applied, Bowel Disease Questionnaire and Short Form Health Survey. Intestinal biopsies were offered if there were any positive autoantibody or seronegative FMs with gastrointestinal symptoms and HLA-DQ at risk for CD. RESULTS: We recruited 111 index cases that had 579 FMs, of whom 344 (59%) were investigated. The average screening rate among families was 65%. A positive tTGA test was found in 47 (14%), 33 with a positive EMA test. CD was diagnosed in 39 (21 males), with an estimated prevalence of 11% (lambda(R) = 16.1). All affected FMs carried the at-risk genotypes. Twenty-one (54%) had "silent" disease, most with severe intestinal villous atrophy. Carrying HLA-DQ2 (odds ratio, 16.1; 95% confidence interval, 2.1-123) and being a sibling (odds ratio, 2.5; 95% confidence interval, 1.1-5.8) are high-risk factors for CD. CONCLUSIONS: CD is more common in first-degree relatives than previously reported in the United States, with siblings having the greatest risk. There is male preponderance of new cases, and many had silent disease despite severe histologic injury. A more proactive case-finding strategy in FMs might improve the diagnostic rate of CD in North America. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/18585974/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(08)00336-4 DB - PRIME DP - Unbound Medicine ER -