Clinical implications
Dr. Gould and colleagues noted that celiac disease was considered histologically severe – with a Marsh III score or higher – among nearly all patients whose condition was diagnosed because of family history. Histology was equally severe regardless of whether the patients were symptomatic or asymptomatic at screening – 100% of symptomatic patients had a high score, and 96% of asymptomatic patients had a high score.
“This emphasizes the importance of celiac screening in all patients with first-degree relatives with celiac disease, as symptom status does not predict diagnosis or severity of disease,” they wrote.
Previous studies have indicated that the prevalence of celiac disease is highest among siblings of patients with celiac disease, compared with other types of first-degree relatives, the authors wrote. However, they lacked this information in their records, which would be valuable for analysis in future studies.
In addition, ongoing research should investigate the optimal frequency of screening for first-degree relatives, they noted.
“One study suggests that individuals screened before 10 years of age should have repeat screening in their second decade for a small increased pick-up of diagnoses,” they wrote.
No funding for the study has been reported. The authors have disclosed no relevant financial relationships.
A version of this article first appeared on Medscape.com.