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  • Jefferson Adams
    Jefferson Adams

    Celiac Risks Much Higher for First Degree Relatives of People with Celiac Disease

    Reviewed and edited by a celiac disease expert.

    A new study reinforces celiac risks for first degree relatives of people with celiac disease, even without symptoms.

    Celiac Risks Much Higher for First Degree Relatives of People with Celiac Disease - Relative Motion. Image: Public Domain Mark 1.0--comedy_nose
    Caption: Relative Motion. Image: Public Domain Mark 1.0--comedy_nose

    Celiac.com 11/28/2022 - First-degree relatives of people with celiac disease have much higher celiac disease rates than the general population, but there isn't much data on the clinical characteristics of the relatives as a group.

    To get a better idea of the exact level of risk, a team of Canadian researchers recently carried out a retrospective review of patients who visited a pediatric celiac disease clinic. 

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    The researchers conducted a retrospective review of 227 patients (144 girls and 83 boys) who were diagnosed with biopsy-proven celiac disease between 1996 and 2014, with an average age of 8 years old at diagnosis. All patients were screened using tissue transglutaminase (tTG-IgA) tests with normal IgA immunoglobulin level for their age. Out of the 227 celiac patients, 49 (21.6%) were initially screened because a first-degree relative had celiac disease, and out of this group 24 (49%) were symptomatic, while 25 (51%) were asymptomatic.

    The 49 first-degree relatives had equally severe Marsh biopsy scores whether they were symptomatic or asymptomatic, and compared to the 178 patients who were screened for other reasons 149 (83.7%) were symptomatic, and 29 (16.3%) were asymptomatic. Interestingly their was no significant difference between the different patient groups' biopsy Marsh scores or tTG-IgA levels at screening.

    According to the researchers:

    • "Although 51% of patients screened due to an affected first-degree relative were asymptomatic, their disease histology was as severe as those screened for symptoms suggestive of celiac disease. These findings support current recommendations to screen all first-degree relatives of patients with celiac disease regardless of clinical symptoms."

    The findings support current recommendations to screen all first-degree relatives of patients with celiac disease, even in the absence of clinical symptoms.

    If you have an unscreened first-degree relative, a mother, father, brother, sister, son or daughter, it's a good idea for them to get screened, especially if they have symptoms, but even if they don't, as "silent " celiac disease can be an issue for many of these folks.

    Read more in the Journal of Pediatric Gastroenterology and Nutrition and at medscape.com.

     

    The research team included Michelle J Gould; Jenna Dowhaniuk; Jorge Arredondo; Paul Azzopardi; Tina Hu; Heather Mileski; Andrea Carpenter; Nikhil Pai; and Herbert Brill. They are variously affiliated with the Department of Paediatrics, University of Toronto, Toronto, ON, Canada; the Division of Gastroenterology and Nutrition, Department of Paediatrics, McMaster University, Hamilton, ON, Canada; the Department of Pathology, McMaster University, Hamilton, ON, Canada; the Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; the Department of Medicine, University of Toronto, Toronto, ON, Canada; The Hospital for Sick Children, Toronto, ON, Canada; the Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Canada; the Department of Pediatrics, William Osler Health System, Brampton, ON, Canada; and McMaster Children’s Hospital, Hamilton, ON, Canada.



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    Amy CH

    I am so thankful that my father, who died of lymphoma due to undiagnosed Celiac urged me to get tested.  I had absoluted no symtoms, but thought why not?  My new doctor basically ridiculed me, asking, "Why would you want to be screened for Celiac?  Don't you know you would have to go on a special diet?"  My response:  "Isn't it better to be proactive?"  She scoffed at me and I will never forget when she called me with the undeniable results that proved Celiac.  Of course I got the endoscopy too.  Thank God I found out because I caught it on the early side before there was much damage to my system.  I feel so fortunate because in our country Celiac is not on the radar of most medical doctors.  Doctors  do not do routnine screenings to rule it out like they do in countries like Italy.  The blood test is so simple.  I know it is not the gold standard, but it is a starting point that could help and surprise so many like it did for me.  Life on a gluten-free diet is really fine after adjusting to it for about a year.  It's been 14 years since I was diagnosed and I am so thankful that I tested when I did. Thanks to my dad who died way too young, still in his 60s.

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    trents

    Thanks for sharing, Amy CH.

    This study concurs with the findings of another study done released about a year ago, done by the Mayo Clinic, that found 44% of first degree relatives of those who had been diagnosed with celiac disease had celiac disease themselves. Most of them didn't have a clue because they were largely asymptomatic.

    Edited by trents
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    cristiana

    I had no trouble getting my children tested, because they frequently complain about gastric issues, as do many children, but when I asked a doctor (at my consultant's suggestion) to test my parents it was not done because my parents had no obvious gastric issues.  And yet my poor mother had osteoporosis and suffered from anxiety.  I don't like battling against doctors, they have a hard enough job as it is, and I realise the NHS has so much else to deal with, but I just wish in the UK there was more awareness that an absence of gastric issues does not mean that someone is in the clear.

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    Guest CindyC

    I was diagnosed 12 years ago in 2010 at age of 33. I had bloat, gas, bad cramps in left side, and what felt like a, smothering coal like, constant burning feeling that came up through my chest, (different feel from heartburn). I thought I had some kind of cancer by the time I went to see my doctor about it, (dealt with it for a year, as it gradually got worse). I had blood work and an endoscopy which all came back super positive. Finding out it was genetic I told my over weight sister about it, (she had intestinal issues since I can remember). The Dr. told her because of her weight it was unlikely she had celiac but went ahead and tested her. She was also positive for Celiac. It makes me a little mad now because when we eat together she will say things like, “I think you are more sensitive than I am because I can eat gluten once in awhile and feel nothing.”  Grrrrr! I myself strictly stay away from gluten and contamination because I know that even if you feel nothing you are still doing damage to your body. I just do not know how to get that through her head. Also I wish my mom and now passed dad would and would of got tested. I feel like piece of mind that they are healthy as can be is a great thing, but because of no symptoms they do not feel need of tested. (My dad who just passed at 89 yr old, had tremors that Neurologist  said was not Parkinson’s and he was super rigid the last 2 years which left him wheel chair bound. I kind of have to wonder if this was due to possible malnutrition based on having undiagnosed Celiac. 

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    Guest WandaC

    My daughter was diagnosed 9 years ago at the age of 11.  Took 11 years to get that diagnosed!! She always had issues. Anyway turn out I al The generic carrier ans one of my other 2 children also has the gene for it. It was explained to me that we should have blood work to screen for celiac every year or sooner if we have issues because it could become active at any time in our system.  Does this sound like reliable information and protocol to you? Should we be doing anything different? What type of cancer lymphoma come from celiac? My mother now deceased from lung cancer also had non Hodgkin lymphoma. She was never tested for celiac. 

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    trents

    @WandaC, that seems like reasonable advice except for the part about waiting to be screened until "until we have issues". I take that to mean you are saying if you start having symptoms. Perhaps the main point of the research article is that you don't want to wait until you start having symptoms because by then the damage to the small bowel lining and other body systems can be significant. A more proactive approach would be to schedule regular testing, maybe yearly, if your insurance and medical system will allow for it. If not, there are home test kits available from companies like Imaware for around $100 USD.

    Small bowel lymphoma rates are definitely higher in the celiac population than in the general population. The rate is still low, meaning the chance of a celiac getting SB lymphoma is pretty low, but it is higher than in the general population. If I recall correctly, it is 4x greater but don't quote me on that.

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    Jefferson Adams

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University. His articles, essays, poems, stories and book reviews have appeared in numerous magazines, journals, and websites, including North American Project, Antioch Review, Caliban, Mississippi Review, Slate, and more. He is the author of more than 2,500 articles on celiac disease. His university coursework includes studies in science, scientific methodology, biology, anatomy, physiology, medicine, logic, and advanced research. He previously devised health and medical content for Colgate, Dove, Pfizer, Sharecare, Walgreens, and more. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of numerous books, including "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

    >VIEW ALL ARTICLES BY JEFFERSON ADAMS

     


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