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Celiac disease seropositivity in Saharawi children: a follow-up and family study
Saverio Teresi1, Mimì Crapisi, Maria Dolores Cantarero Vallejo
1Analysis Laboratory, G Di Cristina Children's Hospital, Palermo, Spain.
Insights
Celiac disease (CD) risk is only modestly increased in Saharawi first-degree relatives. Poor adherence to the gluten-free diet (GFD) may contribute to ongoing CD-related health issues in treated patients.
Area of Science:
- Gastroenterology
- Genetics
- Public Health
Background:
- Celiac disease (CD) is prevalent in the Saharawi population.
- A study investigated CD serology in treated patients and first-degree relatives.
Purpose of the Study:
- To assess CD serology status in treated Saharawi CD patients.
- To determine the prevalence of CD in first-degree relatives of Saharawi patients.
Main Methods:
- 975 individuals from 212 families were tested for CD antibodies (anti-transglutaminase, anti-endomysial).
- Serological screening was performed on first-degree relatives.
Main Results:
- 42.2% of treated CD patients had borderline/positive anti-transglutaminase; 36.6% were anti-endomysial positive.
- 33 new CD cases were identified in relatives. CD prevalence among first-degree relatives was 8.5% (95% CI 6.5-10.5).
- Sibling relative risk for CD was 1.5.
Conclusions:
- First-degree relatives of Saharawis have a modestly increased risk of CD.
- Higher frequency of CD-predisposing genes in the general population may explain this.
- Poor adherence to the gluten-free diet (GFD) in treated Saharawi patients is a concern.
Background:
Celiac disease (CD) is a common disease in the Saharawi population of Arab-Berber origin. Saharawi patients with CD and their families were invited to participate in a follow-up study aimed at checking the CD serology status in patients being treated with the gluten-free diet (GFD) and investigating the prevalence of CD in first-degree relatives.
Patients And Methods:
We investigated 975 subjects (62.8% females and 37.2% males, age range 0.7 to 75.4 years, median age 13.4 years) belonging to 212 families, by determining the serum immunoglobulin A anti-transglutaminase and anti-endomysial antibody levels. Thirty-two first-degree relatives were already receiving GFD when tested.
Results:
Overall, 42.2% of the 244 treated subjects with CD showed a borderline/positive anti-transglutaminase determination, and 36.6% were also anti-endomysial positive. The serologic family screening detected 33 previously undiagnosed CD cases. The 65 affected first-degree relatives were sibling (42), mother (12), son/daughter (7), and father (4). The overall prevalence of CD among first-degree relatives was 65 of 763 (8.5%, 95% confidence interval 6.5-10.5). Based on our previous estimate of CD prevalence in the pediatric Saharawi population (5.6%), the sibling relative risk was 1.5.
Conclusions:
The risk of CD in the Saharawis is only modestly increased in first-degree relatives compared with the general population, probably because of the higher frequency of CD predisposing genes in the general population. Saharawi patients with CD receiving GFD showed poor adherence to the treatment, which could contribute to residual CD-related morbidity and mortality.
