title: HLA-DQ types of celiac disease in Libyan children with type 1 diabetes mellitus.
abstract: OBJECTIVE
  To determine the genetic profile of celiac disease (CD) in Libyan children with type 1 diabetes as there are no data on the frequency of human leukocyte antigen (HLA)-related CD-predisposing genes in diabetic patients in Libya.
  
  
  METHODS
  We randomly studied 218 Libyan type 1 diabetic children. The mean age was 12.2±4.6 years; 56% were female patients. The mean duration of diabetes was 4.7±4.0 years. All patients were screened for CD with IgA tissue-transglutaminase (tTG) and endomysium antibodies. Patients with positive immunological screen were programmed for a small-bowel biopsy. HLA-DRB1* and HLA-DQB1* were genotyped in all tTG-positive patients.
  
  
  RESULTS
  Twenty-seven (12.4%) out of 218 patients with type1 diabetes had positive tTG, and 20 (9.2%) of these patients were positive for endomysium antibodies. Five patients (5/27) were already known cases of biopsy-proven CD. Biopsy was not performed in two patients. One biopsy result was normal, whereas 19 biopsies demonstrated morphological changes consistent with CD. Forty-eight percent of the anti-tTG-positive group were homozygous for HLA-DQ2, whereas 75% of biopsy-proven CD patients had HLA-DQ2, 21% had HLA-DQ2/DQ8, and 4% had HLA-DQ8. In addition, the majority (70%) carried HLA-DQ2 linkage with HLA-DRB1*03.
  
  
  CONCLUSIONS
  Overall, biopsy-confirmed prevalence of CD was 11% (24 of 218). The present study confirms that CD in the Libyan type 1 diabetic population is high when compared with European and US studies, and for the first time we document that this population shares similar HLA-DQ2 genotype. This supports the theory regarding the role of the environment as an important factor in CD development in this part of the world.
authors: Department of Pediatrics, DISM, University of Udine, Piazzale Santa Maria Delle Misericordia 15, Udine, Italy. ghamillad@hotmail.com
authors: Millad
authors: M
authors: Ghawil
authors: Valeria
authors: V
authors: Miotti
authors: Elio
authors: E
authors: Tonutti
authors: Alfred
authors: A
authors: Tenore
authors: Ibtisam
authors: I
authors: Hadeed
authors: Chiara
authors: C
authors: Sindici
authors: Daniela
authors: D
authors: Visentini
authors: Amel
authors: A
authors: Morgham
authors: Sulieman
authors: S
authors: Abusrewil
mesh_terms: D000293:Adolescent; D001323:Autoantibodies / Q000097:blood; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology / Q000235:genetics*; D005260:Female; D008040:Genetic Linkage; D020022:Genetic Predisposition to Disease; D006683:HLA-DQ Antigens / Q000235:genetics*; D059811:HLA-DRB1 Chains / Q000235:genetics; D006650:Histocompatibility Testing / Q000379:methods; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D008002:Libya / Q000453:epidemiology; D008297:Male; D012155:Reticulin / Q000276:immunology; D011503:Transglutaminases / Q000276:immunology; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D006683:HLA-DQ Antigens; C053186:HLA-DQ2 antigen; D059811:HLA-DRB1 Chains; D007070:Immunoglobulin A; D012155:Reticulin; D011503:Transglutaminases