title: Prevalence of celiac disease in first-degree relative of children in Sistan and Baluchestan province (Iran).
abstract: OBJECTIVE
  To determine the prevalence of elevated antibodies and histological changes of celiac disease (CD) on intestinal biopsies among first-degree relatives (FDR) of Iranian children with known CD and to describe the characteristics of the affected FDR.
  
  
  METHODS
  The FDR of 119 patients with CD in Iran were tested for tissue transglutaminase (TTG) and immunoglobulin A (IgA) levels. Upper endoscopy and duodenal biopsy were recommended to those with elevated TTG-IgA antibodies. The characteristics and clinical features of all CD patients were recorded.
  
  
  RESULTS
  Altogether 480 FDR (52.7% females) participated in the study, of whom 63 had an elevated TTG-IgA and 44 consented to undergo endoscopy with biopsies. Histology revealed Marsh 0 in six, Marsh I in seven, Marsh II in four and Marsh III in 27. Most of those with Marsh II or III changes were siblings (26/31). The prevalence of TTG-IgA positivity among FDR was 13.1% and for biopsy-confirmed CD (Marsh II and III) it was 6.5%. Most FDR with CD had symptoms, with the most common being abdominal pain (45.0%), followed by musculoskeletal pain (35.5%) and constipation (25.8%). FDR with Marsh III changes had significantly higher levels of TTG-IgA.
  
  
  CONCLUSIONS
  The prevalence of CD in FDR in Iran is much higher compared with the general population (6.5% vs 0.5-0.6%). Testing should be considered for all FDR of Iranian patients with known CD and in particular in symptomatic cases.
authors: Department of Pediatrics, Faculty of Medicine, Zahedan University of Medical Sciences, Research Center for Children and Adolescent Health, Zahedan, Islamic Republic of Iran.
authors: Touran
authors: T
authors: Shahraki
authors: Department of Pediatrics, Ohio State University School of Medicine and Nationwide Children's Hospital, Columbus, USA.
authors: Ivor
authors: I
authors: Hill
mesh_terms: D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000097:blood; D001706:Biopsy; D002446:Celiac Disease / Q000453:epidemiology* / Q000235:genetics* / Q000276:immunology / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D004386:Duodenum / Q000473:pathology; D005260:Female; D019204:GTP-Binding Proteins / Q000276:immunology; D020022:Genetic Predisposition to Disease; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases / Q000276:immunology; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D007070:Immunoglobulin A; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins
keywords: Iran; celiac disease; child; first-degree relative; prevalence