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Serologic and Genetic Markers Identify Celiac Disease in First-Degree Relatives of Patients

Dig Dis Sci 1999;44:2344-2349.

Celiac.com 04/10/2000 - Dr. Carme Farre, of Hospital Sant Joan de Deu, in Barcelona, Spain, and his multi-center colleagues, report in the November issue of Digestive Diseases and Sciences that both serologic markers and the human lymphocyte antigen class II extended DQ2 (HLA-DQ2) haplotype are useful markers for screening first-degree relatives of patients with celiac disease for the disorder. These markers are more reliable predictors of celiac disease than other clinical features, which are absent from one third of relatives of people with celiac disease.

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The researchers examined the usefulness of serologic markers, HLA-DQ2 haplotype, and clinical features common to celiac disease in the diagnosis of the disorder in 675 first-degree relatives of celiac disease patients. The diagnosis was confirmed by intestinal biopsy. Their results showed that 5.5% of the subjects were diagnosed with celiac disease, which is significantly higher than what was observed in the general public in a previous study. Serum IgA-class anti-endomysium antibodies (IgA-AEA) and IgA-class anti-gliadin antibodies (IgA-AGA) were observed in 5.8% and 1.9% of the relatives, respectively.

According to the researchers: Our results show that IgA-AEA is the most useful marker, since all but one IgA-AEA-positive relative showed histological findings of [celiac disease]. Further, the measurement of IgA-AGA would have missed 66% of the affected relatives. The researchers also concluded that the HLA-DQ2 haplotype also appeared to be a more useful indicator to determine which first-degree relatives had an increased genetic susceptibility to celiac disease, because the marker was detected in 93% of first-degree relatives found to have celiac disease, and 18% of those without it. The four most common clinical symptoms for celiac disease, diarrhea, anemia, food intolerance and growth retardation, were not found in one third of the relatives of patients with celiac disease.

The researchers conclude: Although the definitive diagnosis of [celiac disease] relies upon the intestinal biopsy, it should be preceded by a noninvasive, inexpensive and easy-to-perform screening technique. Their findings indicate that using blood serum IgA-AEA measurements is a useful screening tool for noninvasive screening, and HLA-DQ2 assessment may delineate a very high risk population with a particular genetic susceptibility to [celiac disease].

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1 Response:

 
Sandra Garren
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said this on
11 Dec 2014 6:43:11 AM PDT
My Natropath has told me that I don't have celiac, but that I do have celiac markers. Not sure if this is legit. She says I should be gluten free based on this. I DO have IBS and diverticulosis. Do I really need to be GF?




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JaneWhoLovesRain, what is odder to me than that there is an older disease that Doctor's have forgotten that explains many of the same symptom's and doctor's do not even think about it today since the "War on Pellagra" was declared over a 100 years and why doctor's don't (at least in the West) think about it any more. Dr. Heaney wrote a nice online article about this topic. http://blogs.creighton.edu/heaney/2013/11/18/pellagra-and-the-four-ds/ Here is fairly recent article about how Pellagra can present in patients and the title says' it all from the International Journal of Dermatology. https://www.researchgate.net/publication/227807440_Pellagra_Dermatitis_dementia_and_diarrhea Dermatitis, dementia and Diarrhea are the 3 D's (4th D is death) of Pellagra. Typically it is only diagnosed today if you are in a subset of the population like an alcoholic for example or you have a gastric bypass. See this article from the New England Journal of Medicine http://www.nejm.org/doi/full/10.1056/NEJMicm050641 and despite all the signs of Pellagra (skin issues etc.) . . .. Pellagra in it native tongue (Italian) where it was first diagnosed was called "rough/sour skin" who knows that today??????? Very few I would venture to guess. The NEJM can only say they have "Pellagra-like dermatitis" it has been so long since any doctor's seen it they can't (with confidence) diagnose it clinically. But taking Niacinamide 3/day for 6 months can help alleviate your symptom's if indeed the DH of Celiac is the dermatitis of Pellagra being medically misdiagnosed. Here is a an article featured on celiac.com about why/how Pellagra can be confused for Celiac disease. https://www.celiac.com/articles/24658/1/A-Differential-Diagnosis-How-Pellagra-Can-be-Confused-with-Celiac-Disease/Page1.html Because they haven't seen Pellagra in 75+ years no one recognizes it anymore. ****this is not medical advice. I hope this is helpful. Knitty Kitty and I are the Niacin warriors on this board. See this thread where Knitty Kitty says Niacin helped the itching of DH. If that is so then it might help your DH (if you have it) and your GI problems too if they are caused by co-morbid Pellagra. see my blog post about where I say "I had Celiac Disease and Developed Pellagra" that talks about this in more detail. Again good luck and your continued journey and I hope this is helpful. 2 Timothy 2: 7 ?Consider what I say; and the Lord give thee understanding in all things? this included. posterboy by the grace of God,

I should say I am confused about how to interpret--- Does this mean celiac or no celiac? Thank you all---I greatly appreciate it.

KathleenH, I swear by MatteosPizza and they make National Delivery. I have been known to buy them by the dozen. https://www.matteospizza.com/ BellaMonica's is not a bad corn based crust. By not bad I mean "suprisingly good" that can be bought at most grocery stores. Here is there ZIP locator page to see if they are carried in your local area. http://glutenfreepizza.typepad.com/gluten-free-pizza/where-to-find-bella-monica.html I hope this is helpful. posterboy,

Hey all--have Hashimoto's and am being worked up for epigastric discomfort and IBS like symptoms--- My blood work had an IgA within the lower end of normal range, negative TTG, but weakly positive DGP. My endoscopy showed a "nodular" duodenum with the biopsy stating there was "reactive lymphoid hyperplasia"... I have a follow-up with the GI in 3 weeks. Wondering about any help?

DH wasn't linked to celiacs until 1967 from my research...