Celiac disease in relation to immunologic serum markers, trace elements, and HLA-DR and DQ antigens in Swedish children with Down syndrome

Background: An association between Down syndrome and celiac disease has bee n reported. This study was conducted to determine the association between c hildhood celiac disease and Down syndrome in the county of Uppsala, Sweden. Methods: All 76 children with Down syndrome (1-18 years) were screened for the occurrence of anti-gliadin antibodies (AGA) and anti-endomysium antibod ies (ER IA). Twelve children with suspected celiac disease were investigate d further. Results: Increased levels of both IgA and Ige AGA were found in 26% of die children and of EMA in and 5 of 76. Celiac disease was diagnosed in at leas t three of the children (3.9%; 95% confidence interval 0%-8.3%), and it cou ld have been present in as many as eight. Three of the five EMA-positive ch ildren with suspected celiac disease had the HLA phenotype DR3, DQ2. Conclusions: The results show that determination of EMA is more useful as a screening test for celiac disease and for fallow-up than is AGA in childre n with Down syndrome, The present study also confirms that celiac disease i s overrepresented among Swedish children with Down syndrome and that celiac disease should be considered in all persons with Down syndrome.