Abstract
BACKGROUND: There is evidence of an increased prevalence of coeliac disease in Down's syndrome. AIMS: To investigate the association, patients with Down's syndrome and matched controls were examined. METHODS: Fifty nine patients with Down's syndrome residing in government institutions in the Hunter region of New South Wales were studied. Four were excluded (terminally ill = 1, uncooperative = 3). Each of 55 patients was matched for age, sex, and residence with a control patient. Patients with both positive IgA and IgG antigliadin antibodies were considered for endoscopical duodenal biopsy. RESULTS: Twenty one patients and two controls had raised IgA and IgG antibodies (chi 2 = 19.4; p < 0.001). Tissue was obtained in 18 patients. Two had characteristic flat, five pronounced lymphocytic infiltration not diagnostic of coeliac disease, two giardiasis, and eight were normal. In one the tissue was not suitable for analysis. There were few differences between the subgroups in their anthropomorphic, biochemical, or haematological findings. CONCLUSIONS: The prevalence of coeliac disease in these 51 patients with Down's syndrome is at least two (3.9%; 95% confidence interval (95% CI) 0%-9.2%) and could be as many as seven (13.7%; 95% CI 4.3%-23.2%). In this community the prevalence of coeliac disease in Down's syndrome is increased more than 100-fold (x135-473).
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Selected References
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- Bentley D. A case of Down's syndrome complicated by retinoblastoma and celiac disease. Pediatrics. 1975 Jul;56(1):131–133. [PubMed] [Google Scholar]
- Burgio G. R., Nespoli L. Letter: Ageing, T lymphocytes, and Down's syndrome. Lancet. 1974 Dec 28;2(7896):1580–1580. doi: 10.1016/s0140-6736(74)90336-5. [DOI] [PubMed] [Google Scholar]
- Castro M., Crinò A., Papadatou B., Purpura M., Giannotti A., Ferretti F., Colistro F., Mottola L., Digilio M. C., Lucidi V. Down's syndrome and celiac disease: the prevalence of high IgA-antigliadin antibodies and HLA-DR and DQ antigens in trisomy 21. J Pediatr Gastroenterol Nutr. 1993 Apr;16(3):265–268. [PubMed] [Google Scholar]
- Corrao G., Corazza G. R., Andreani M. L., Torchio P., Valentini R. A., Galatola G., Quaglino D., Gasbarrini G., di Orio F. Serological screening of coeliac disease: choosing the optimal procedure according to various prevalence values. Gut. 1994 Jun;35(6):771–775. doi: 10.1136/gut.35.6.771. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dias J. A., Walker-Smith J. Down's syndrome and coeliac disease. J Pediatr Gastroenterol Nutr. 1990 Jan;10(1):41–43. [PubMed] [Google Scholar]
- Gjertsen H. A., Lundin K. E., Sollid L. M., Eriksen J. A., Thorsby E. T cells recognize a peptide derived from alpha-gliadin presented by the celiac disease-associated HLA-DQ (alpha 1*0501, beta 1*0201) heterodimer. Hum Immunol. 1994 Apr;39(4):243–252. doi: 10.1016/0198-8859(94)90267-4. [DOI] [PubMed] [Google Scholar]
- Greco L., Auricchio S., Mayer M., Grimaldi M. Case control study on nutritional risk factors in celiac disease. J Pediatr Gastroenterol Nutr. 1988 May-Jun;7(3):395–399. doi: 10.1097/00005176-198805000-00013. [DOI] [PubMed] [Google Scholar]
- Hilhorst M. I., Brink M., Wauters E. A., Houwen R. H. Down syndrome and coeliac disease: five new cases with a review of the literature. Eur J Pediatr. 1993 Nov;152(11):884–887. doi: 10.1007/BF01957522. [DOI] [PubMed] [Google Scholar]
- Howell S. J., Foster K. J., Reckless J. Protracted survival in patients with Down's syndrome. Br Med J (Clin Res Ed) 1983 Nov 12;287(6403):1429–1430. doi: 10.1136/bmj.287.6403.1429-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Iacono G., Cavataio F., Balsamo V., Carroccio A., Montalto G., Notarbartolo A. Celiac disease in Down's syndrome: considerations on the role of histocompatibility antigens. J Pediatr Gastroenterol Nutr. 1990 Feb;10(2):273–273. [PubMed] [Google Scholar]
- Kanavin O., Scott H., Fausa O., Ek J., Gaarder P. I., Brandtzaeg P. Immunological studies of patients with Down's syndrome. Measurements of autoantibodies and serum antibodies to dietary antigens in relation to zinc levels. Acta Med Scand. 1988;224(5):473–477. [PubMed] [Google Scholar]
- Ladinser B., Rossipal E., Pittschieler K. Endomysium antibodies in coeliac disease: an improved method. Gut. 1994 Jun;35(6):776–778. doi: 10.1136/gut.35.6.776. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Levo Y., Green P. Down's syndrome and autoimmunity. Am J Med Sci. 1977 Jan-Feb;273(1):95–99. doi: 10.1097/00000441-197701000-00010. [DOI] [PubMed] [Google Scholar]
- Marsh M. N., Cummins A. G. The interactive role of mucosal T lymphocytes in intestinal growth, development and enteropathy. J Gastroenterol Hepatol. 1993 May-Jun;8(3):270–278. doi: 10.1111/j.1440-1746.1993.tb01199.x. [DOI] [PubMed] [Google Scholar]
- Marsh M. N. Gluten, major histocompatibility complex, and the small intestine. A molecular and immunobiologic approach to the spectrum of gluten sensitivity ('celiac sprue'). Gastroenterology. 1992 Jan;102(1):330–354. [PubMed] [Google Scholar]
- Nespoli L., Burgio G. R., Ugazio A. G., Maccario R. Immunological features of Down's syndrome: a review. J Intellect Disabil Res. 1993 Dec;37(Pt 6):543–551. doi: 10.1111/j.1365-2788.1993.tb00324.x. [DOI] [PubMed] [Google Scholar]
- Nilsen E. M., Lundin K. E., Krajci P., Scott H., Sollid L. M., Brandtzaeg P. Gluten specific, HLA-DQ restricted T cells from coeliac mucosa produce cytokines with Th1 or Th0 profile dominated by interferon gamma. Gut. 1995 Dec;37(6):766–776. doi: 10.1136/gut.37.6.766. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nowak T. V., Ghishan F. K., Schulze-Delrieu K. Celiac sprue in Down's syndrome: considerations on a pathogenetic link. Am J Gastroenterol. 1983 May;78(5):280–283. [PubMed] [Google Scholar]
- Reading C. M. Down's syndrome: nutritional intervention. Nutr Health. 1984;3(1-2):91–111. doi: 10.1177/026010608400300208. [DOI] [PubMed] [Google Scholar]
- Ruch W., Schürmann K., Gordon P., Bürgin-Wolff A., Girard J. Coexistent coeliac disease, Graves' disease and diabetes mellitus type 1 in a patient with Down syndrome. Eur J Pediatr. 1985 May;144(1):89–90. doi: 10.1007/BF00491938. [DOI] [PubMed] [Google Scholar]
- Similä S., Kokkonen J. Coexistence of celiac disease and Down syndrome. Am J Ment Retard. 1990 Jul;95(1):120–122. [PubMed] [Google Scholar]
- Storm W. Prevalence and diagnostic significance of gliadin antibodies in children with Down syndrome. Eur J Pediatr. 1990 Sep;149(12):833–834. doi: 10.1007/BF02072069. [DOI] [PubMed] [Google Scholar]
- Sturgess R., Day P., Ellis H. J., Lundin K. E., Gjertsen H. A., Kontakou M., Ciclitira P. J. Wheat peptide challenge in coeliac disease. Lancet. 1994 Mar 26;343(8900):758–761. doi: 10.1016/s0140-6736(94)91837-6. [DOI] [PubMed] [Google Scholar]
- Weinstein W. M. Latent celiac sprue. Gastroenterology. 1974 Apr;66(4):489–493. [PubMed] [Google Scholar]
- Zubillaga P., Vitoria J. C., Arrieta A., Echaniz P., Garcia-Masdevall M. D. Down's syndrome and celiac disease. J Pediatr Gastroenterol Nutr. 1993 Feb;16(2):168–171. doi: 10.1097/00005176-199302000-00012. [DOI] [PubMed] [Google Scholar]
