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.

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