ABSTRACT
BACKGROUND: Celiac disease (CD) is an autoimmune disease that affects genetically predisposed individuals. The HLA-DQ2 heterodimer is present in nearly 90% of patients while HLA-DQ8 is found in the remaining 10%. AIM: To study the characteristics of CD in pediatric patients in Cantabria and their first-degree relatives, with special emphasis on factors related to haplotype, serology, and forms of clinical presentation. PATIENTS AND METHODS: Eighty-six patients with CD and 215 first-degree relatives were HLA genotyped. Clinical, laboratory, immunologic, and histological data were obtained from all patients. RESULTS: Clinical presentation was classical in 95% of the patients and mono-symptomatic in the remaining 5%. Anti-gliadin antibodies (AGA) and anti-transglutaminase antibodies (ATGA) were positive in 95% of the patients and negative in 5% (all with IgA deficiency). DQ2 was found in 71% of the patients (homozygotes or heterozygotes) and DQ8 was found in 9.5%. No heterodimers of risk were found in 22%. CD was found in six relatives (three were positive for AGA and four were positive for ATGA). Forty-nine percent of the relatives carried the DQ2 heterodimer and 15% the DQ8 heterodimer; no heterodimers of risk were found in 40%. CONCLUSIONS: The most prevalent HLA found in patients with CD in the autonomous region of Cantabria was DQ2 (71%). This prevalence is clearly lower than that reported in other Spanish regions. The prevalence of CD among first-degree relatives was similar to that found in other studies performed in Spain (2.8%). Our data support the need for systematic study of the first-degree relatives of patients with CD.
Subject(s)
Celiac Disease/epidemiology , Genes, MHC Class II , HLA-DQ Antigens/genetics , Adolescent , Adult , Autoantibodies/blood , Autoantibodies/immunology , Celiac Disease/genetics , Celiac Disease/immunology , Child , Child, Preschool , Dimerization , Female , Gene Frequency , Genetic Predisposition to Disease , Genotype , Gliadin/immunology , HLA-DQ Antigens/chemistry , Humans , Infant , Male , Parents , Protein Multimerization , Retrospective Studies , Siblings , Spain/epidemiology , Transglutaminases/immunologyABSTRACT
Introducción: La enfermedad celíaca (EC) es una entidad mediada por fenómenos autoinmunes, que se presenta en sujetos susceptibles genéticamente. El 90% de los pacientes presenta el heterodímero HLA-DQ2, y el 10% restante suele presentar el HLA-DQ8. Objetivo: Estudiar las características de la EC en la población pediátrica de Cantabria y en sus familiares de primer grado, fundamentalmente en los aspectos relacionados con el haplotipo, la serología y sus formas de presentación clí nica. Pacientes y métodos: Estudio de 86 pacientes celíacos y 215 familiares de primer grado. Se recogieron datos clínicos, analíticos, inmunológicos, histológicos y de tipificación genómica. Resultados: El 95% de los caso se iniciaron con clínica clásica y el 5% eran formas monosintomáticas. Un 95% presentaba positividad a anticuerpos antigliadina (AAG) y antitransglutaminasa (AATG), y eran negativos el 5% (todos con déficit de IgA). Genotípicamente, un 71% eran portadores del DQ2 (incluidos los homocigotos y los heterocigotos), y un 9,5% del DQ8. Un 22% no presentaba heterodímero de riesgo. En el estudio familiar se hallaron 6 familiares con EC (3 AAG positivos y 4 AATG positivos). Del total, el 49% de los familiares portaba el DQ2, un 15% el DQ8, y un 40% no presentaba el heterodímero de riesgo. Conclusiones: El HLA más prevalente en nuestra comunidad fue el DQ2 (71%), claramente menor que lo publicado en nuestro medio. La prevalencia de EC en familiares de primer grado fue similar al resto de España (2,8%). Nuestros datos apoyan la necesidad del estudio sistemático en familiares de primer grado de pacientes celíacos
Background: Celiac disease (CD) is an autoimmune disease that affects genetically predisposed individuals. The HLA-DQ2 heterodimer is present in nearly 90% of patients while HLA-DQ8 is found in the remaining 10%. Aim: To study the characteristics of CD in pediatric patients in Cantabria and their first-degree relatives, with special emphasis on factors related to haplotype, serology, and forms of clinical presentation. Patients and methods: Eighty-six patients with CD and 215 first-degree relatives were HLA genotyped. Clinical, laboratory, immunologic, and histological data were obtained from all patients. Results: Clinical presentation was classical in 95% of the patients and mono-symptomatic in the remaining 5%. Anti-gliadin antibodies (AGA) and anti-transglutaminase antibodies (ATGA) were positive in 95% of the patients and negative in 5% (all with IgA deficiency). DQ2 was found in 71% of the patients (homozygotes or heterozygotes) and DQ8 was found in 9.5%. No heterodimers of risk were found in 22%. CD was found in six relatives (three were positive for AGA and four were positive for ATGA). Forty-nine percent of the relatives carried the DQ2 heterodimer and 15% the DQ8 heterodimer; no heterodimers of risk were found in 40%. Conclusions: The most prevalent HLA found in patients with CD in the autonomous region of Cantabria was DQ2 (71%). This prevalence is clearly lower than that reported in other Spanish regions. The prevalence of CD among first-degree relatives was similar to that found in other studies performed in Spain (2.8%). Our data support the need for systematic study of the first-degree relatives of patients with CD
