Low-Risk Human Leukocyte Antigen Genes and Mild Villous Atrophy Typify Celiac Disease With Immunoglobulin A Deficiency.
J Pediatr Gastroenterol Nutr
; 72(6): 889-893, 2021 06 01.
Article
em En
| MEDLINE
| ID: mdl-33908742
ABSTRACT
OBJECTIVES:
We aimed to establish if in celiac disease (CD) with immunoglobulin A deficiency (IgAD) duodenal histopathology is influenced by human leukocyte antigen (HLA)-DQB1∗02 alleles dosage. Clinical differences between patients with CD and patients with CD and IgAD (CD-IgAD) were also evaluated.METHODS:
Five hundred and sixteen CD and 16 patients with CD-IgAD, enrolled over the time of 8âyears, took part in this study. The severity of duodenal histopathology and frequency of CD at-risk HLA class II genes were compared in patients with CD versus patients with CD-IgAD. HLA class II genotypes were subdivided into two categories of genetic risk high HLA-DR3/DR7, -DR3/DR3, -DR4/DR4â-DR3/DR4 and low HLA-DR5/DR7, -DR3/X, -DR4/X and X/X, where X means neither -DR3 nor -DR4. Then, they were compared with two types of duodenal histopathology 0, 1, 2 and 3a of mild villous atrophy (MVA) and 3b and 3c of severe villous atrophy (SVA) according to the Marsh-Oberhuber classification. Clinical data concerning gender, number of esophagogastroduodenoscopies (EGDs) and association with other autoimmune diseases were obtained from medical records.RESULTS:
In comparison with CD, CD-IgAD showed an increased frequency of MVA (Pâ<â0.0001). Furthermore, CD-IgAD with MVA showed an increase of HLA low-risk genotypes (Pâ=â0.036) and half HLA-DQ2 heterodimers (Pâ=â0.0443). Interestingly, CD-IgAD demanded an increased number of EGDs to reach the diagnosis of CD (Pâ=â0.0104) and autoimmune liver diseases were more frequent compared to CD (Pâ=â0.0049).CONCLUSIONS:
CD-IgAD is associated with MVA, low-risk HLA class II genes, an increased number of EGDs and autoimmune liver diseases.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença Celíaca
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
J Pediatr Gastroenterol Nutr
Ano de publicação:
2021
Tipo de documento:
Article