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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