Wheat, rye, and barley proteins induce celiac disease in genetically susceptible persons.
Celiac disease may be underdiagnosed.
In the study, a team of researchers from Finland estimated the prevalence of the disease in children. They also tested whether assays for serum autoantibodies can be used to detect untreated celiac disease, and whether positive findings correlate with specific HLA haplotypes.
The team collected serum samples from 3654 students (aged between 7 and 16 years) in 1994. These were screened in 2001 for endomysial and tissue transglutaminase antibodies.
|All but 2 of the antibody-positive subjects had the HLA-DQ2 or HLA-DQ8 haplotype.|
|New England Journal of Medicine|
The researchers also performed HLA typing on the stored blood samples.
In addition, the team asked all antibody-positive subjects to undergo small-bowel biopsy in 2001.
The research team found that 1.5% had positive antibody tests. Furthermore, the results of the 2 antibody tests were highly concordant.
In 1994, no subject had received a diagnosis of celiac disease, but 10 antibody-positive subjects were diagnosed between 1994 and 2001.
An additional 36 subjects with positive antibody assays underwent biopsy in 2001. Of these subjects, 27 had evidence of celiac disease.
The researchers estimated that prevalence was 1 case in 99 children.
They found that all but 2 of the antibody-positive subjects had either the HLA-DQ2 or the HLA-DQ8 haplotype.
The team determined that the prevalence of antibody positivity and an HLA haplotype associated with celiac disease was 1 in 67.
Dr Markku Mäki's team concluded, "The presence of serum tissue transglutaminase and endomysial autoantibodies is predictive of small-bowel abnormalities indicative of celiac disease".
"There is a good correlation between autoantibody positivity and specific HLA haplotypes".
"We estimate that the prevalence of celiac disease among Finnish schoolchildren is at least 1 case in 99 children".