There is a greater prevalence of celiac disease in the family members of celiac disease patients.
In this study, Dr Alberto Rubio-Tapia and colleagues determined the clinical, serologic, and genetic predictors of celiac disease in family members of a population-based cohort of index cases.
The 111 index cases were all from southeast Minnesota; cases provided contact information for their first-degree relatives.
The team examined 344 family members for endomysial and tissue transglutaminase antibodies, as well as HLA-DQ genotypes.
Family members also completed 2 questionnaires: the Bowel Disease Questionnaire and Short Form Health Survey.
The research team also offered intestinal biopsies to any positive autoantibody or seronegative family members with GI symptoms and HLA-DQ at risk for celiac disease.
The average screening rate among families was 65%.
|Over half the affected family members had "silent" disease.|
|Clinical Gastroenterology and Hepatology|
The research team found that 47 family members were positive for tissue transglutaminase antibodies. Of these, 33 had a positive endomysial antibodies test.
The team diagnosed celiac disease in 39 family members. They estimated the overall prevalence in first-degree relatives at 11%.
Furthermore, they determined that all affected family members carried the at-risk genotypes.
However, over half the affected family members had "silent" disease, many with severe intestinal villous atrophy.
Overall, the team found that carrying HLA-DQ2 and being a sibling were high-risk factors for celiac disease.
Dr Alberto Rubio-Tapia's team concluded, "Celiac disease 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 family members might improve the diagnostic rate of celiac disease in North America."