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Celiac.com 09/02/2019 - A team of researchers recently set out to investigate rates of first-degree relatives (FDRs) with celiac disease detected at screening, and the diagnostic significance of anti-tissue transglutaminase (anti-TTG). The research team included Shilpa S. Nellikkal, MBBS, Yamen Hafed, MD, Joseph J. Larson, BS, Joseph A. Murray, MD, and Imad Absah, MD. They are variously affiliated with the the Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota; the Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota; and the Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota. Using data from the Mayo Clinic going back to 1983, the team conducted a retrospective study on a group of 104 patients diagnosed with celiac disease and their first-degree relatives. The data included demographics, original symptoms, reasons for testing, family history, number of other family members screened, biopsy reports, and results of serologic tests. The team screened 360 out of a total of 477 first-degree relatives, finding a total of 160 first-degree relatives who were diagnosed with celiac disease, 62% of whom were female. All diagnosed first-degree relatives had positive anti-TTG titers. They found clinical features in 148 diagnosed first-degree relatives. Just nine of those diagnosed first-degree relatives had classic symptoms, 97 showed non-classic symptoms, and 42 showed no symptoms. Histology reports from 155 first-degree relatives showed 12 with Marsh 1, 77 with Marsh 3a, and 66 with Marsh 3b. The team used levels of anti-TTG greater than or equal to 2.75 of the upper limit of normal to spot first-degree relatives with villous atrophy with 87% sensitivity, 82% specificity, and a positive predictive value of 95%. This study of diagnosed celiac patients showed high rates of celiac disease among screened first-degree relatives. Small bowel biopsies revealed that high anti-TTG titers were associated with villous atrophy, irrespective of symptoms. Read more at Mayoclinicproceedings.org.
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