Akademik Veri Yönetim Sistemi
52. ESPGHAN, Glasgow, Birleşik Krallık, 5 - 08 Haziran 2019, cilt.68, sa.1, ss.592
Objectives and Study: Coeliac disease (CD) is an autoimmune enteropathy triggered by gluten
ingestion in genetically susceptible individuals. HLA-DQ2/DQ8 heterodimers on antigen-presenting
cells elicits a T-cell response, and plays a key role in pathogenesis. Recent reports regarding the
concurrent occurrence of CD and inflammatory bowel diseases (IBD) pointed out an association in the
pathogenesis. The aim of this study is to determine the prevalence of coeliac related HLA haplotypes
in our inflammatory bowel disease cohort.
Methods: A total number of 134 paediatric IBD patients were evaluated, and patients younger than 2
years old and those diagnosed with primary immune deficiency were excluded (n=125). A blood
sample was drawn for anti-tissue transglutaminase (anti-tTG) and anti endomysium (EMA) IgA
antibodies. Further, HLA DQ2 (DQB1*02, DQA1*05) and DQ8 (HLADQB1*03:02) haplotypes were
assessed in 73 patients. The results were compared between Crohn's disease (CrD) and ulcerative
colitis (UC) patients.
Results: The study group (n=125) included 57 (45.6%) children with CrD, 66 (52.8%) with UC and 2
(1.6%) with unclassified IBD. None of the patients had coeliac related histopathology, and both antitTG,
anti-EMA antibodies were negative in all patients. Among 73 patients, 22 (30.1%) and 39 (53.4%)
possessed HLA DQB1*02 and HLADQA1*05 alleles respectively, whereas both HLA DQB1*02 and
DQA1*05 (DQ2.5) alleles were positive in 19.2% of the patients. HLA DQB1*03:02 allele was
possessed by 17.8% of the patients in our study group. The number of patients who were positive for
HLA DQB1*02, DQA1*05 or HLA DQB1*02 and HLADQA1*05 alleles were comparable in Crohn's
disease and ulcerative colitis groups and there was no statistically significant difference between the
groups.
Conclusion: The association between CD and IBD has been reported previously in adult population
however, there is scarce data in paediatric age group. Though the seroprevalence of celiac disease is
around 1-2% in this country, none of the IBD patients in the study group were positive for CD specific
antibodies. However, our results demonstrated that HLA DQB1*02, DQA1*05 and HLA DQB1*03:02
alleles that are associated with genetic susceptibility to CD are more prevalent in this IBD cohort than
the figures reported in general population (30.1% versus 16-23%, 53.4% versus 32% and 17.8%
versus 12.8% respectively). Since these shared genetic features may act as a risk factor for the
development of CD in patients with inflammatory bowel disease, celiac serology should be monitored
during the follow-up of IBD patients.