PMID- 11922565
OWN - NLM
STAT- MEDLINE
DCOM- 20020419
LR  - 20220331
IS  - 0002-9270 (Print)
IS  - 0002-9270 (Linking)
VI  - 97
IP  - 3
DP  - 2002 Mar
TI  - HLA-DQ typing in the diagnosis of celiac disease.
PG  - 695-9
AB  - OBJECTIVE: More than 95% of celiac patients share the major histocompatibility 
      complex II class human leukocyte antigen (HLA) DQ2 or DQ8 haplotype; patients 
      negative for both types are unlikely to suffer from celiac disease. Our aim was 
      to investigate whether HLA-DQ2 and -DQ8 typing is helpful when diagnosis is 
      uncertain because of the absence of unequivocal small bowel villous atrophy. 
      METHODS: HLA-DQ2 and -DQ8 typing was carried out in 59 patients evincing 
      nondiagnostic small bowel mucosal lesion or positive celiac serology, and in 17 
      patients maintaining a gluten-free diet without biopsy-proven celiac disease. HLA 
      findings were compared to small bowel mucosal morphology; intraepithelial 
      lymphocytes; and serum endomysial (EmA), reticulin, tissue transglutaminase 
      (anti-tTG) and gliadin antibodies. RESULTS: Of the 59 patients evincing only 
      minor small bowel mucosal changes or positive celiac disease serology, 22 (37%) 
      were negative for DQ2 and DQ8. All EmA-positive patients had celiac-type HLA, but 
      antireticulin antibody, anti-tTg, and antigliadin antibody were also present in 
      HLA-DQ2- and -DQ8-negative individuals. Eleven of 17 patients (65%) observing a 
      gluten-free diet before small bowel biopsy did not share celiac-type HLA. None of 
      the 17 had apparent villous atrophy. Serum EmA and anti-tTG were negative in all. 
      HLA-DQ typing is less expensive than follow-up biopsy in the exclusion of celiac 
      disease. CONCLUSIONS: HLA-DQ2 and -DQ8 determination is useful in exclusion, 
      probably lifelong, of celiac disease in individuals with an equivocal small bowel 
      histological finding. The low specificity of this test must, however, be borne in 
      mind.
FAU - Kaukinen, Katri
AU  - Kaukinen K
AD  - Department of Internal Medicine, Tampere University Hospital, Finland.
FAU - Partanen, Jukka
AU  - Partanen J
FAU - Maki, Markku
AU  - Maki M
FAU - Collin, Pekka
AU  - Collin P
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Gastroenterol
JT  - The American journal of gastroenterology
JID - 0421030
RN  - 0 (HLA-DQ Antigens)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Atrophy/blood/pathology
MH  - Celiac Disease/*blood/*pathology
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - HLA-DQ Antigens/*blood
MH  - *Histocompatibility Testing
MH  - Humans
MH  - Infant
MH  - Intestinal Mucosa/pathology
MH  - Intestine, Small/pathology
MH  - Male
MH  - Middle Aged
MH  - Sensitivity and Specificity
EDAT- 2002/04/02 10:00
MHDA- 2002/04/20 10:01
CRDT- 2002/04/02 10:00
PHST- 2002/04/02 10:00 [pubmed]
PHST- 2002/04/20 10:01 [medline]
PHST- 2002/04/02 10:00 [entrez]
AID - 10.1111/j.1572-0241.2002.05471.x [doi]
PST - ppublish
SO  - Am J Gastroenterol. 2002 Mar;97(3):695-9. doi: 10.1111/j.1572-0241.2002.05471.x.