title: Cross-sectional study of coeliac autoimmunity in a population of Vietnamese children.
abstract: The prevalence of coeliac disease (CD) in Vietnam is unknown. To fill this void, we assessed the prevalence of serological markers of CD autoimmunity in a population of children in Hanoi.
  
  
  
  The outpatient blood drawing laboratory of the largest paediatric hospital in North Vietnam was used for the study, which was part of an international project of collaboration between Italy and Vietnam.
  
  
  
  Children having blood drawn for any reason were included. Exclusion criteria were age younger than 2 years, acquired or congenital immune deficiency and inadequate sample. A total of 1961 children (96%) were enrolled (838 females, 1123 males, median age 5.3 years).
  
  
  
  Primary outcome was the prevalence of positive autoimmunity to both IgA antitransglutaminase antibodies (anti-tTG) assessed with an ELISA test and antiendomysial antibodies (EMA). Secondary outcome was the prevalence of CD predisposing human leucocyte antigens (HLA) (HLA DQ2/8) in the positive children and in a random group of samples negative for IgA anti-tTG.
  
  
  
  The IgA anti-tTG test was positive in 21/1961 (1%; 95% CI 0.61% to 1.53%); however, EMA antibodies were negative in all. HLA DQ2/8 was present in 7/21 (33%; 95% CI 14.5% to 56.9%) of the anti-tTG-positive children and in 72/275 (26%; 95% CI 21% to 32%) of those who were negative.
  
  
  
  Coeliac autoimmunity is rare in Vietnam, although prevalence of HLA DQ2/8 is similar to that of other countries. We hypothesise that the scarce exposure to gluten could be responsible for these findings.
authors.affiliation: Department of Medical Sciences/Pediatrics, University of Ferrara, Ferrara, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Zanella
authors.affiliation: Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy.
authors.forename: Luigina
authors.initials: L
authors.lastname: De Leo
authors.affiliation: National Hospital of Pediatrics, Hanoi, Vietnam.
authors.forename: Le
authors.initials: L
authors.lastname: Nguyen-Ngoc-Quynh
authors.affiliation: National Hospital of Pediatrics, Hanoi, Vietnam.
authors.forename: Bo
authors.initials: B
authors.lastname: Nguyen-Duy
authors.affiliation: Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy.
authors.forename: Tarcisio
authors.initials: T
authors.lastname: Not
authors.affiliation: National Hospital of Pediatrics, Hanoi, Vietnam.
authors.forename: Mai
authors.initials: M
authors.lastname: Tran-Thi-Chi
authors.affiliation: National Hospital of Pediatrics, Hanoi, Vietnam.
authors.forename: Son
authors.initials: S
authors.lastname: Phung-Duc
authors.affiliation: National Hospital of Pediatrics, Hanoi, Vietnam.
authors.forename: Hai
authors.initials: H
authors.lastname: Le-Thanh
authors.affiliation: Department of Medical Sciences/Pediatrics, University of Ferrara, Ferrara, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Malaventura
authors.affiliation: Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Vatta
authors.affiliation: Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Ziberna
authors.affiliation: Department of Medical Sciences/Pediatrics, University of Ferrara, Ferrara, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Mazzocco
authors.affiliation: Department of Medical Sciences/Pediatrics, University of Ferrara, Ferrara, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Volpato
authors.affiliation: National Hospital of Pediatrics, Hanoi, Vietnam.
authors.forename: Lan
authors.initials: L
authors.lastname: Phung-Tuyet
authors.affiliation: National Hospital of Pediatrics, Hanoi, Vietnam.
authors.forename: Huong
authors.initials: H
authors.lastname: Le-Thi-Minh
authors.affiliation: Department of Medical Sciences/Pediatrics, University of Ferrara, Ferrara, Italy.
authors.forename: Caterina
authors.identifier: 0000-0002-2577-6871
authors.initials: C
authors.lastname: Borgna-Pignatti
mesh_terms: D001323:Autoantibodies / Q000097:blood*; D015551:Autoimmunity / Q000235:genetics* / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D002446:Celiac Disease / Q000097:blood / Q000453:epidemiology / Q000235:genetics*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005838:Genotype; D006683:HLA-DQ Antigens / Q000097:blood*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D007558:Italy; D008297:Male; D015995:Prevalence; D011503:Transglutaminases / Q000097:blood*; D014744:Vietnam / Q000453:epidemiology
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D006683:HLA-DQ Antigens; C053186:HLA-DQ2 antigen; D007070:Immunoglobulin A; D011503:Transglutaminases
keywords: EMA; EPIDEMIOLOGY; HLA DQ2/DQ8; anti-tTG; gluten