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Risk factors in familial forms of celiac disease – Source: World Journal of Gastroenterology, Apr 21, 2010

  [ 36 votes ]   [ Discuss This Article ]
By Hugh James Freeman, MD, CM, FRCPC, FACP • • April 22, 2010

[Note: To read the full text of this article free, click here. It has important implications for at-risk families.]

Celiac disease has been reported in up to 2% of some European populations. A similar risk has been identified in America and Australia where immigration of Europeans has occurred. Moreover, an increasing number of celiac disease patients are being identified in many Asian countries, including China and India. Finally, celiac disease has also been detected in Asian immigrants and their descendants to other countries, such as Canada.

Within these so-called "general" celiac populations, however, there are specific high risk groups that have an even higher prevalence of celiac disease.

• Indeed, the single most important risk factor for celiac disease is having a first-degree relative with already-defined celiac disease, particularly a sibling. A rate up to 20% or more has been noted.

• Risk is even greater if a specific family has 2 siblings affected, particularly if a male carries the human leukocyte antigen-DQ2 [associated with celiac disease and a constellation of other immune disorders such as type 1 diabetes, RA, MS, psoriasis].

• Both structural changes in the small bowel architecture occur along with functional changes in permeability, even in asymptomatic first-degree relatives.

• Even if celiac disease is not evident, the risk of other autoimmune disorders seems significantly increased in first-degree relatives - as well as intestinal lymphoma.

• Identification of celiac disease is important since recent long-term studies have shown that the mortality of celiac disease is increased, if it is unrecognized and untreated.

Source: World Journal of Gastroenterology, Apr 21, 2010;16(15):1828-31. PMID: 20397258, by Freeman HJ. Department of Medicine, University of British Columbia Hospital, Vancouver, BC, Canada. [Email:]

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