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Prevalence of Celiac Disease High in First-Degree Relatives

FDRs with villous atrophy identified with high sensitivity and specificity by anti-TTG ≥2.75 of ULN

FRIDAY, Aug. 23, 2019 (HealthDay News) — The prevalence of celiac disease is higher among screened first-degree relatives (FDRs) of patients with celiac disease, according to a study published online Aug. 22 in the Mayo Clinic Proceedings.

Shilpa S. Nellikkal, M.B.B.S., from the Mayo Clinic in Rochester, Minnesota, and colleagues performed a retrospective cohort study involving 104 patients with celiac disease and their FDRs. Demographics, presenting symptoms, indication for testing, family history, number of other family members screened, biopsy reports, and results of serologic testing were obtained.

The researchers found that 360 of 477 FDRs identified were screened (mean screening rate per family, 79 ± 25 percent) and 160 FDRs (44 percent) were diagnosed with celiac disease. Positive antitissue transglutaminase (anti-TTG) titers were identified in all diagnosed FDRs. In 148 diagnosed FDRs, clinical features were documented: 6, 66, and 28 percent had classic, nonclassic, and no reported symptoms, respectively. Histology reports were obtained from 155 FDRs: 8, 50, and 43 percent had Marsh 1, Marsh 3a, and Marsh 3b, respectively. FDRs with villous atrophy were identified by a level of anti-TTG ≥2.75 of the upper limit of normal with sensitivity, specificity, and a positive predictive value of 87, 82, and 95 percent, respectively.

“Larger multicenter prospective studies are required to confirm anti-TTG titers as a diagnostic test among FDRs,” the authors write.

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