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Published on: December 15, 2011
Characteristics of Pediatric Patients With Celiac Disease Identified Due to an Affected First-Degree Family Member
Michelle J Gould1, Jenna Dowhaniuk2,3, Jorge Arredondo4
1From the Department of Paediatrics, University of Toronto, Toronto, ON, Canada.
Insights
Screening first-degree relatives for celiac disease (an autoimmune disorder) is crucial. Even asymptomatic relatives can have severe disease, supporting current screening recommendations.
Area of Science:
- Gastroenterology and Immunology
- Pediatric Health
- Genetics and Hereditary Diseases
Background:
- Celiac disease incidence is elevated in first-degree relatives.
- Clinical characteristics of this high-risk group remain underdescribed.
- Current screening guidelines recommend testing relatives regardless of symptoms.
Purpose of the Study:
- To describe the clinical characteristics of pediatric celiac disease patients identified through family screening.
- To compare disease severity in symptomatic versus asymptomatic relatives diagnosed with celiac disease.
Main Methods:
- Retrospective review of patients diagnosed with celiac disease at a tertiary pediatric clinic.
- Identification of 49 patients screened due to an affected first-degree relative.
- Analysis of clinical presentation and histological findings.
Main Results:
- 51% of relatives screened were asymptomatic at diagnosis.
- Asymptomatic patients exhibited disease histology as severe as symptomatic patients.
- No significant difference in histological severity was observed between symptomatic and asymptomatic screened relatives.
Conclusions:
- Screening first-degree relatives for celiac disease is essential, irrespective of symptoms.
- Asymptomatic relatives can present with significant histological disease burden.
- Findings reinforce the importance of universal screening in pediatric celiac disease families.
Abstract:
The incidence of celiac disease in first-degree relatives of affected individuals is higher than in the general population, yet the clinical characteristics of this unique subset of patients has not been well described. Through a retrospective review of patients seen in a tertiary care pediatric celiac disease clinic, we identified 49 patients diagnosed with celiac disease following screening due to an affected first-degree relative. Although 51% of patients screened due to an affected first-degree relative were asymptomatic, their disease histology was as severe as those screened for symptoms suggestive of celiac disease. These findings support current recommendations to screen all first-degree relatives of patients with celiac disease regardless of clinical symptoms.
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