title: Early developing celiac disease in children with cerebral palsy.
abstract: OBJECTIVE
  We have reported on increased levels of antibodies against gliadin and/or transglutaminase 2 (TG2) in children with cerebral palsy (CP) but without having increased prevalence of celiac disease (CD). The aim of the present study was to evaluate whether these children have mucosal signs of early developing CD, human leukocyte antigen (HLA)-DQ2/DQ8, and antibodies against deamidated gliadin peptides (DGP).
  
  
  METHODS
  Stored blood samples from 16 children with CP were analyzed regarding HLA-DQ2/DQ8 and anti-DGP antibodies. HLA-DQ2/DQ8 were analyzed by polymerase chain reaction sequence-specific oligonucleotide probes. Anti-DGP antibodies were analyzed with enzyme-linked immunosorbent assay. Small-bowel biopsies from 15 of these children were available for immunohistochemistry regarding IgA colocalized with TG2, densities of α/β+ and γ/δ+ intraepithelial lymphocytes.
  
  
  RESULTS
  Mucosal immunoglobulin A (IgA) deposits colocalized with TG2 were found in the small-bowel biopsy from 1 patient with serum IgA-class anti-TG2 antibodies, HLA-DQ2, and gastrointestinal complaints. Another 2 children had slightly increased numbers of mucosal α/β+ and/or γ/δ+ intraepithelial lymphocytes. In total, 10 of 16 children were HLA-DQ2 and/or DQ8-positive. Anti-DGP antibodies were detected in sera from 4 of 16 children.
  
  
  CONCLUSIONS
  In the present study, 1 child with CP had IgA colocalizing with TG2 in the small-bowel mucosa, suggesting CD at an early stage. Although the majority of children with CP and elevated levels of CD-related seromarkers are HLA-DQ2 and/or DQ8-positive, they have neither classical nor early developing CD.
authors.affiliation: Department of Paediatrics, Örebro University Hospital, Örebro, Sweden. reidun.stenberg@orebroll.se
authors.forename: Reidun
authors.initials: R
authors.lastname: Stenberg
authors.forename: Katri
authors.initials: K
authors.lastname: Kaukinen
authors.forename: Mats
authors.initials: M
authors.lastname: Bengtsson
authors.forename: Eva
authors.initials: E
authors.lastname: Lindberg
authors.forename: Charlotte
authors.initials: C
authors.lastname: Dahle
mesh_terms: D000293:Adolescent; D000906:Antibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001706:Biopsy / Q000379:methods; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D002547:Cerebral Palsy / Q000150:complications* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019204:GTP-Binding Proteins / Q000276:immunology; D005903:Gliadin / Q000276:immunology; D006683:HLA-DQ Antigens / Q000097:blood; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007413:Intestinal Mucosa / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases / Q000276:immunology
chemical_list: D000906:Antibodies; D015415:Biomarkers; D006683:HLA-DQ Antigens; C053186:HLA-DQ2 antigen; C109756:HLA-DQ8 antigen; D007070:Immunoglobulin A; D005903:Gliadin; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins