title: Undiagnosed celiac disease in women with infertility.
abstract: OBJECTIVE
  To determine the prevalence of celiac disease in a group of Brazilian women with infertility.
  
  
  METHODS
  This was a cross-sectional study of 170 infertile Brazilian women tested for immunoglobulin A anti-tissue transglutaminase (IgA anti-tTG), endomysial antibody and total IgA. Women with positive serologies were recommended for intestinal biopsy. Patients with positive serology and villous atrophy on biopsy had the diagnosis of celiac disease, while those with positive serology but no villous atrophy were identified as having latent celiac disease. All of these women were typed for HLA-DQ2 and HLA-DQ8.
  
  
  RESULTS
  The prevalence of celiac disease confirmed by biopsy in the study group was 1.2% (2 out of 170) (95% confidence interval [CI], 0.1-4.2). Considering also those with latent celiac disease, the prevalence was estimated at 2.9% (5 out of 170) (95% CI, 1.0-6.7) and in the subgroup of unexplained infertility the prevalence was 10.3% (3 out of 29) (95% CI, 2.2-27.4). All seropositive patients were also HLA-DQ2 positive.
  
  
  CONCLUSIONS
  Further studies are required to define the role of routine serological screening for celiac disease in infertile women as well as to elucidate the underlying mechanism for infertility in active celiac disease.
authors: Division of Pediatric Gastroenterology and Hepatology, Federal University of Bahia, Brazil. analobomachado@uol.com.br
authors: Ana Paula de Souza Lobo
authors: AP
authors: Machado
authors: Luciana Rodrigues
authors: LR
authors: Silva
authors: Bela
authors: B
authors: Zausner
authors: Joventina de Araújo
authors: Jde A
authors: Oliveira
authors: Daniel Rui
authors: DR
authors: Diniz
authors: Juliana
authors: J
authors: de Oliveira
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases / Q000453:epidemiology; D001323:Autoantibodies / Q000097:blood; D001938:Brazil; D002446:Celiac Disease / Q000453:epidemiology* / Q000235:genetics / Q000276:immunology* / Q000473:pathology; D016001:Confidence Intervals; D003238:Connective Tissue / Q000276:immunology; D003430:Cross-Sectional Studies; D005260:Female; D019204:GTP-Binding Proteins / Q000276:immunology; D006683:HLA-DQ Antigens / Q000235:genetics; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007247:Infertility, Female / Q000453:epidemiology*; D007413:Intestinal Mucosa / Q000473:pathology*; D009132:Muscles / Q000276:immunology; D015995:Prevalence; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D012698:Serologic Tests; D011503:Transglutaminases / Q000276:immunology
chemical_list: D001323:Autoantibodies; D006683:HLA-DQ Antigens; C053186:HLA-DQ2 antigen; C109756:HLA-DQ8 antigen; D007070:Immunoglobulin A; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins