[Increased prevalence of celiac disease in first and second-grade relatives. A report of a family with 19 studied members].
BACKGROUND
celiac disease (CD) is an autoimmune condition that is triggered by the ingestion of gluten, a substance present in most cereals, and that affects genetically predisposed individuals. As a result, this condition is clearly familial, and mainly associated with HLA class II markers.


OBJECTIVE
in this work we set out to analyze the prevalence of CD in an extensive family based on an index subject who had already died from this disease a few years ago, where CD had been complicated by the development of a small-bowel malignancy, namely an adenocarcinoma.


METHODS
nineteen members were studied. They all were subjected to a diagnostic protocol including a detailed medical history, hemogram, coagulation tests, and blood biochemistry (including liver function tests, serum iron metabolism, circulating folic acid and vitamin B12 levels, thyroid function tests, tissue transglutaminase measurement, and genetic markers (DQ2 and DQ8). Suspect cases underwent gastroscopy plus multiple duodenal biopsy for confirmation.


RESULTS
overall we encountered CD in 9/19 studied members, which represents 47.4% with the following distribution according to degree of kinship -four of seven siblings (57%); one of three children (33.3%); three of eight nephews and nieces (37.5%), and the only grandnephew, who was 9 years old.


CONCLUSIONS
from all this it may be seen that family studies are needed every time a patient is diagnosed with celiac disease; these studies should include both first- and second-degree relatives, given the high prevalence encountered and the fact that these tests are relatively straighforward to perform.
Rodrigo
L
L
Servicio de Digestivo, Hospital Universitario Central de Asturias, Oviedo, Spain. lrodrigos@terra.es
Fuentes
D
D
Riestra
S
S
Niño
P
P
Alvarez
N
N
López-Vázquez
A
A
López-Larrea
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D002446:Celiac Disease / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics*; D002648:Child; D005190:Family; D005260:Female; D005802:Genes, MHC Class II / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010375:Pedigree