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Prevalence, human leukocyte antigen typing and strategy for screening among Asian first-degree relatives of children with celiac disease.

Abstract

BACKGROUND AND AIM

Data on prevalence, human leukocyte antigen (HLA) typing and small bowel histology among first-degree relatives of subjects with celiac disease (CD) is scarce. This prospective study evaluated the prevalence and role of HLA DQ2/8 testing in screening of first-degree relatives of children with CD.

METHODS

Thirty confirmed children with CD and 91/94 first-degree relatives (parents and siblings) were enrolled. HLA DQ2/8 testing was carried out in all index CD cases. Clinical evaluation with a questionnaire, total serum immunoglobulin A (IgA), human IgA-tissue transglutaminase (IgA-tTGA) and HLA DQ2/8 testing was carried out in all first-degree relatives. Subjects who were positive for IgA-tTGA were recommended endoscopic duodenal biopsy to document histological changes of CD.

RESULTS

Nine first-degree relatives were positive for IgA-tTGA, seven underwent duodenal biopsy and four subjects had Marsh IIIa changes suggestive of CD. The prevalence of histologically confirmed CD in first-degree relatives was 4.4%. The prevalence of potential CD was 9.8%. IgA-tTGA-positive subjects (4/9) were significantly more often symptomatic than IgA-tTGA-negative first-degree relatives (2/82). Twenty-nine (96.6%) index cases of CD and all IgA-tTGA-positive first-degree relatives were positive for HLA DQ2. None of the index CD cases or first-degree relatives were HLA DQ8-positive. A total of 85% of the first-degree relatives were positive for HLA DQ2 and thus at risk of developing CD.

CONCLUSIONS

In this first Asian study on a limited number of families of children with CD, 4.4% of the first-degree relatives had CD. Only 15% of the first-degree relatives were negative for HLA DQ2/DQ8. Initial evaluation with HLA and serology followed by only serial serology in HLA-positive relatives is recommended.

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  • Authors+Show Affiliations

    ,

    Department of Pediatric Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

    , , , ,

    Source

    MeSH

    Adolescent
    Adult
    Asian Continental Ancestry Group
    Autoantibodies
    Biopsy
    Celiac Disease
    Child
    Child, Preschool
    Duodenoscopy
    Female
    HLA-DQ Antigens
    Histocompatibility Testing
    Humans
    India
    Male
    Mass Screening
    Middle Aged
    Pedigree
    Predictive Value of Tests
    Prevalence
    Prospective Studies
    Risk Factors
    Surveys and Questionnaires
    Transglutaminases

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    19929927

    Citation

    Srivastava, Anshu, et al. "Prevalence, Human Leukocyte Antigen Typing and Strategy for Screening Among Asian First-degree Relatives of Children With Celiac Disease." Journal of Gastroenterology and Hepatology, vol. 25, no. 2, 2010, pp. 319-24.
    Srivastava A, Yachha SK, Mathias A, et al. Prevalence, human leukocyte antigen typing and strategy for screening among Asian first-degree relatives of children with celiac disease. J Gastroenterol Hepatol. 2010;25(2):319-24.
    Srivastava, A., Yachha, S. K., Mathias, A., Parveen, F., Poddar, U., & Agrawal, S. (2010). Prevalence, human leukocyte antigen typing and strategy for screening among Asian first-degree relatives of children with celiac disease. Journal of Gastroenterology and Hepatology, 25(2), pp. 319-24. doi:10.1111/j.1440-1746.2009.06044.x.
    Srivastava A, et al. Prevalence, Human Leukocyte Antigen Typing and Strategy for Screening Among Asian First-degree Relatives of Children With Celiac Disease. J Gastroenterol Hepatol. 2010;25(2):319-24. PubMed PMID: 19929927.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Prevalence, human leukocyte antigen typing and strategy for screening among Asian first-degree relatives of children with celiac disease. AU - Srivastava,Anshu, AU - Yachha,Surender Kumar, AU - Mathias,Amrita, AU - Parveen,Farah, AU - Poddar,Ujjal, AU - Agrawal,Suraksha, Y1 - 2009/11/19/ PY - 2009/11/26/entrez PY - 2009/11/26/pubmed PY - 2010/4/24/medline SP - 319 EP - 24 JF - Journal of gastroenterology and hepatology JO - J. Gastroenterol. Hepatol. VL - 25 IS - 2 N2 - BACKGROUND AND AIM: Data on prevalence, human leukocyte antigen (HLA) typing and small bowel histology among first-degree relatives of subjects with celiac disease (CD) is scarce. This prospective study evaluated the prevalence and role of HLA DQ2/8 testing in screening of first-degree relatives of children with CD. METHODS: Thirty confirmed children with CD and 91/94 first-degree relatives (parents and siblings) were enrolled. HLA DQ2/8 testing was carried out in all index CD cases. Clinical evaluation with a questionnaire, total serum immunoglobulin A (IgA), human IgA-tissue transglutaminase (IgA-tTGA) and HLA DQ2/8 testing was carried out in all first-degree relatives. Subjects who were positive for IgA-tTGA were recommended endoscopic duodenal biopsy to document histological changes of CD. RESULTS: Nine first-degree relatives were positive for IgA-tTGA, seven underwent duodenal biopsy and four subjects had Marsh IIIa changes suggestive of CD. The prevalence of histologically confirmed CD in first-degree relatives was 4.4%. The prevalence of potential CD was 9.8%. IgA-tTGA-positive subjects (4/9) were significantly more often symptomatic than IgA-tTGA-negative first-degree relatives (2/82). Twenty-nine (96.6%) index cases of CD and all IgA-tTGA-positive first-degree relatives were positive for HLA DQ2. None of the index CD cases or first-degree relatives were HLA DQ8-positive. A total of 85% of the first-degree relatives were positive for HLA DQ2 and thus at risk of developing CD. CONCLUSIONS: In this first Asian study on a limited number of families of children with CD, 4.4% of the first-degree relatives had CD. Only 15% of the first-degree relatives were negative for HLA DQ2/DQ8. Initial evaluation with HLA and serology followed by only serial serology in HLA-positive relatives is recommended. SN - 1440-1746 UR - https://www.unboundmedicine.com/medline/citation/19929927/Prevalence_human_leukocyte_antigen_typing_and_strategy_for_screening_among_Asian_first_degree_relatives_of_children_with_celiac_disease_ L2 - https://doi.org/10.1111/j.1440-1746.2009.06044.x DB - PRIME DP - Unbound Medicine ER -