Onset of coeliac disease: a prospective longitudinal study.
OBJECTIVE
To make a prospective assessment of close family members of patients with coeliac disease (CD) by testing their endomysium (EMA) and antigliadin antibodies once a year over a period of 12 y and to investigate whether and when they would develop a positive serology for CD while on a gluten-containing diet.


METHODS
Since first-degree relatives of CD patients have a high prevalence of CD, we screened 92 children and adolescents, all first-degree relatives of coeliac patients, for EMA and total IgA antibodies, once a year.


RESULTS
Among 11 relatives, at the time of the first screening, 6 already had a positive serology and histology for CD, while 5 became positive only after a period of 2 to 5 y of negative testing. The jejunal mucosa biopsy of these five relatives with retarded positive serology for CD showed a flat mucosa in four of them and a partial villous atrophy in one. They were all HLA DQ2 positive and clinically silent for CD.


CONCLUSIONS
CD can manifest itself after years of negative serological testing.
Pittschieler
K
K
Department of Paediatrics, Regional Hospital, Bozen, Italy. klaus.pittschieler@asbz.it
Gentili
L
L
Niederhofer
H
H
D000293:Adolescent; D000328:Adult; D002446:Celiac Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D004198:Disease Susceptibility; D005190:Family; D005260:Female; D005983:Glutens / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007223:Infant; D007583:Jejunum / Q000276:immunology / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D013997:Time Factors
D005983:Glutens