Familial aspects of coeliac disease

The incidence of coeliac disease amongst first-degree relatives of 115 patients with coeliac disease aged between nine and 75 years has been studied. Of 689 relatives 526 were living of whom 324 were willing to be investigated. One hundred and eighty-two relatives underwent jujunal biopsy. Forty-one were considered to have coeliac disease, 22 per cent of those biopsied, or 11-2 per cent of the available relatives. One-third of the relatives discovered to have coeliac disease were asymptomatic but all had at least one abnormal result amongst the laboratory indices used. Twenty-two per cent of the relatives with haemoglobin less than 13-0 g, 43 per cent with serum folate less than 3-0 pg/ml, 24 per cent with serum albumin less than 4-0 g/100 ml, with serum iron less than 60 mug/100 ml or with serum alkaline phosphatase above 13 K.A. units had coeliac disease. Less than 5 per cent of relatives with H.L.A. antigens other than H.L.A. 8 had coeliac disease compared with one in four of those with H.L.A. 8. The high percentage of relatives with H.L.A. 8 antigens or with anticonnective tissue antibodies, amongst those with non-specific biopsy appearances suggests that these groups also contain a number of relatives with varying degrees of gluten intolerance.