PMID- 28387454
OWN - NLM
STAT- MEDLINE
DCOM- 20180222
LR  - 20180222
IS  - 1440-1746 (Electronic)
IS  - 0815-9319 (Linking)
VI  - 32
IP  - 12
DP  - 2017 Dec
TI  - Coeliac disease and gastrointestinal symptom screening in adult first-degree 
      relatives.
PG  - 1931-1937
LID - 10.1111/jgh.13801 [doi]
AB  - BACKGROUND AND AIM: The first-degree relatives (FDRs) of patients with coeliac 
      disease are the main risk group for disease development. The study aims to 
      evaluate the screening strategy in FDRs with negative coeliac serology based on 
      human leukocyte antigen (HLA) genotyping, followed by duodenal biopsy, and to 
      analyze the prevalence of gastrointestinal symptoms and the influence of gluten 
      intake. METHODS: Adult FDRs with negative coeliac serology were invited to 
      participate (n = 205), and a total of 139 completed the study protocol. HLA 
      genotyping, transglutaminase antibody assessment, and duodenal biopsy were 
      performed. Symptomatology was assessed using questionnaires during the various 
      phases of dietary modification (baseline diet, gluten-free diet, and gluten 
      overload). RESULTS: The study included 139 participants (mean age, 42 years; 
      53.2% women). HLA-DQ2/8 was positive in 78.4% of the participants (homozygous, 
      15.1%; heterozygous, 63.3%). Histopathological alterations were noted in 37.1% of 
      participants who underwent duodenal biopsy (Marsh I, 32.7%; Marsh IIIa, 4.4%). At 
      baseline, symptoms were observed in 45.7% of the participants, and the proportion 
      decreased to 24.5% after the gluten-free diet (P < 0.001). Symptoms were not 
      associated with the presence of histological alterations or genetic risk. 
      However, younger age (odds ratio [OR] = 0.91), female sex (OR = 2.9), and the 
      presence of autoimmune disorders (OR = 2.8) were independently associated with a 
      significant symptom response to the gluten-free diet. CONCLUSIONS: Duodenal 
      lymphocytosis and atrophy are frequently noted in FDRs, despite negative 
      serological markers. In addition, gastrointestinal symptoms are commonly present 
      and associated with gluten intake regardless of the histological pathology.
CI  - (c) 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & 
      Sons Australia, Ltd.
FAU - Vaquero, Luis
AU  - Vaquero L
AD  - Department of Gastroenterology, Department of Biomedical Sciences, University of 
      Leon, Leon, Spain.
FAU - Rodriguez-Martin, Laura
AU  - Rodriguez-Martin L
AD  - Department of Gastroenterology, Department of Biomedical Sciences, University of 
      Leon, Leon, Spain.
FAU - Alvarez-Cuenllas, Begona
AU  - Alvarez-Cuenllas B
AD  - Department of Gastroenterology, Department of Biomedical Sciences, University of 
      Leon, Leon, Spain.
FAU - Hernando, Mercedes
AU  - Hernando M
AD  - Department of Pathology, University of Leon, Leon, Spain.
FAU - Iglesias-Blazquez, Cristina
AU  - Iglesias-Blazquez C
AD  - Department of Paediatrics, University Hospital of Leon, University of Leon, Leon, 
      Spain.
FAU - Menendez-Arias, Cristina
AU  - Menendez-Arias C
AD  - Department of Paediatrics, University Hospital of Leon, University of Leon, Leon, 
      Spain.
FAU - Vivas, Santiago
AU  - Vivas S
AD  - Department of Gastroenterology, Department of Biomedical Sciences, University of 
      Leon, Leon, Spain.
LA  - eng
PT  - Journal Article
PL  - Australia
TA  - J Gastroenterol Hepatol
JT  - Journal of gastroenterology and hepatology
JID - 8607909
RN  - 0 (HLA Antigens)
RN  - 8002-80-0 (Glutens)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Autoimmune Diseases
MH  - Biopsy
MH  - Celiac Disease/*diagnosis/etiology/*genetics/physiopathology
MH  - Diet, Gluten-Free
MH  - Duodenum/pathology
MH  - *Family
MH  - Female
MH  - *Genetic Testing/methods
MH  - Genotype
MH  - Genotyping Techniques
MH  - Glutens/administration & dosage/adverse effects
MH  - HLA Antigens/genetics
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Risk
MH  - Serology/methods
MH  - Sex Factors
MH  - Surveys and Questionnaires
MH  - *Symptom Assessment
MH  - Young Adult
OTO - NOTNLM
OT  - coeliac disease
OT  - duodenal lymphocytosis
OT  - gluten-free diet
OT  - non-coeliac gluten sensitivity
EDAT- 2017/04/08 06:00
MHDA- 2018/02/23 06:00
CRDT- 2017/04/08 06:00
PHST- 2016/10/24 00:00 [received]
PHST- 2017/03/03 00:00 [revised]
PHST- 2017/04/06 00:00 [accepted]
PHST- 2017/04/08 06:00 [pubmed]
PHST- 2018/02/23 06:00 [medline]
PHST- 2017/04/08 06:00 [entrez]
AID - 10.1111/jgh.13801 [doi]
PST - ppublish
SO  - J Gastroenterol Hepatol. 2017 Dec;32(12):1931-1937. doi: 10.1111/jgh.13801.