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Don’t fight Celiac disease alone.
Find your community on the free RareGuru App.Celiac disease is an autoimmune disorder that damages the small intestine and inhibits absorption of nutrients. People with celiac disease cannot tolerate gluten, a protein in wheat, rye, barley, and in some products such as medicines, vitamins, and lip balms. When affected people eat food with gluten, or use a product with gluten, the immune system reacts by damaging tiny parts of the lining of the small intestine called villi. Because villi normally allow the blood to absorb nutrients from food, affected individuals become malnourished. Classic signs and symptoms are caused by inflammation of the gastrointestinal tract and may include diarrhea, weight loss, abdominal pain, swelling, and food intolerance. However, many people have other symptoms involving many body systems, and some people have no symptoms. While celiac disease tends to run in families, it does not follow a specific inheritance pattern. The risk to develop celiac disease is raised by having certain forms of the HLA-DQA1 and HLA-DQB1 genes. Treatment is a lifelong, gluten-free diet.
Source: GARD Last updated on 05-01-20
Celiac disease is a systemic autoimmune disease with gastrointestinal symptoms as well as multiple, but variable, non- gastrointestinal symptoms. Signs and symptoms may begin from early childhood to adulthood. In adults, the age at diagnosis is usually between 30 and 50. On average, the time between the first symptoms and diagnosis is about 11 years due to the wide range of non-specific symptoms and lack of symptoms in some people.
Gastrointestinal symptoms of celiac disease may include chronic or recurrent diarrhea; malabsorption; abdominal pain and distention; bloating; vomiting; and weight loss. People with mild to severe gastrointestinal symptoms are usually said to have 'classic celiac disease.'
Non-gastrointestinal symptoms of celiac disease may include dermatitis herpetiformis; chronic fatigue; joint pain/inflammation; iron-deficiency anemia; migraines; depression; attention-deficit disorder; epilepsy; osteoporosis/osteopenia; infertility and/or recurrent miscarriage; vitamin deficiencies; short stature; failure to thrive; delayed puberty; dental enamel defects; and various secondary autoimmune disorders. People without prominent gastrointestinal symptoms are often said to have 'nonclassic celiac disease,' which is more common than classic celiac disease. Iron-deficiency anemia is the most common finding of nonclassic celiac disease, and may be the only finding.
Some affected people have no symptoms (often identified because of an affected family member or screening) and are said to have 'silent celiac disease.'
Last updated on 05-01-20
A person is considered to have HLA-DQ2 and/or HLA-DQ8 celiac disease susceptibility if they have a combination of particular versions (alleles) of the HLA- DQA1 and HLA- DQB1 genes, which are located on chromosome 6. These combinations are referred to as haplotypes.
The HLA-DQ2 celiac disease susceptibility haplotype can be inherited either in an autosomal dominant or autosomal recessive manner, depending on the specific alleles of these genes the parent has. HLA-DQ8 celiac disease susceptibility haplotype is inherited in an autosomal dominant manner. However, even if a child inherits HLA-DQ2 and/or HLA-DQ8 celiac disease susceptibility, it does not mean the child will have celiac disease. Susceptibility to celiac disease can be inherited, but the disease itself is not inherited.
Each child of a person with HLA-DQ2 or HLA-DQ8 celiac disease-susceptibility haplotype has a 50% (1 in 2) chance to inherit each haplotype. However, the child of an affected person who has DQ2 celiac disease-susceptibility due to specific alleles on both copies of chromosome 6 (versus on 1 copy of chromosome 6) will definitely inherit one of the susceptibility haplotypes. Genetic testing can show whether a person has the alleles on one chromosome or both chromosomes.
Because the genetics of celiac disease are complicated, individuals who have specific questions about their genetic test results, or risks to themselves and family members, should speak with a genetics professional.
Last updated on 05-01-20
A Punnett square is a diagram that may be used to find the chance to inherit a specific trait, when the genotype of both parents is known. It shows each possible combination of one maternal allele (version of a gene) with one paternal allele. However, Punnett squares are mainly used with traits that follow Mendelian inheritance; this means they are used for traits or conditions that are inherited in an autosomal dominant, autosomal recessive, X-linked dominant, or X-linked recessive manner.
Celiac disease is caused by the interaction of multiple genes, both with each other and with environmental factors. Celiac disease does not follow a simple Mendelian inheritance pattern, and therefore the inheritance cannot be illustrated by a Punnett square. Even though alleles that cause susceptibility to celiac disease are passed on in a Mendelian inheritance pattern, they are not enough to determine whether celiac disease will occur. In addition to environmental factors that contribute to celiac disease, other genes which are less well-understood are thought to play a role.
People who have specific questions about genetic risks for themselves or family members should speak with a genetics professional.
Last updated on 05-01-20
Susceptibility to developing celiac disease (CD) can be inherited, but the disease itself is not inherited. Celiac disease is a multifactorial disorder, which means that multiple genes interact with environmental factors to cause CD. The condition is due to the interaction of the genes HLA-DQA1 and HLA-DQB1 (known to be associated with CD susceptibility); non-HLA genes that are less well-understood; gliadin (a component of gluten); and other environmental factors. While multifactorial disorders can run in families, they generally do not follow a specific inheritance pattern.
The risk for a relative of an affected person to develop CD is mostly based on empiric risk data. This means that the risk is assumed based on what has been reported, and the experiences of many families with affected people. However, genetic testing of the genes that cause susceptibility to CD can help people get a more personal risk assessment. For example, when the genetic status of an affected person's child is unknown, the child's overall risk for CD is 5-10% (1/10 to 1/20). However, if the child has testing of the susceptibility genes, the risk will increase or decrease depending on the results.
Individuals interested in learning about specific risks for themselves or family members should speak with their health care provider or a genetics professional.
Last updated on 05-01-20
Celiac disease causes inflammation of the small bowel, damage to the villi (small, finger-like projections that protrude from the lining of the intestinal wall), and subsequent malabsorption of nutrients. Inflammation in the gastrointestinal (GI) tract causes many of the classic GI symptoms of celiac disease. This inflammation damages the villi, causing them to become shortened and flattened, thus unable to effectively absorb nutrients. The inflammation as well as poor nutrient absorption may lead to the non-GI signs and symptoms of celiac disease. However, the exact underlying causes of the non-GI symptoms are not well understood.
Last updated on 05-01-20
The HLA genes known to increase susceptibility to celiac disease are called HLA- DQA1 and HLA- DQB1. These genes provide directions for making proteins used by the immune system. They belong to a family of genes called the human leukocyte antigen (HLA) complex, which helps the immune system distinguish between proteins that belong in the body from those made by foreign invaders such as viruses and bacteria. The proteins made by these 2 genes attach to each other to form bigger proteins called heterodimers, which attach to proteins outside cells and help the body decide if they are foreign. The heterodimers respond differently depending on the versions (alleles) of the HLA-DQA1 and HLA- DQB1 genes a person has.
Specific combinations of HLA-DQA1 and HLA-DQB1 gene alleles, called haplotypes, are associated with susceptibility to CD. The HLA-DQ2 haplotype results from certain HLA- DQA1 alleles, and the HLA-DQ8 haplotype results from certain HLA-DQB1 alleles.
30% of the population has one of the CD-associated HLA alleles causing DQ2 and/or DQ8 susceptibility, but only 3% of people with one or both of these develop CD. Therefore, having these alleles does not mean a person has, or will have, CD. However, not having DQ2 and DQ8 susceptibility reduces a person's risk for CD to under 1% (less than 1 in 100).
It is also known that:
Last updated on 05-01-20
You can learn more about the genetics of celiac disease by clicking on the following links. If you have questions regarding this information, it is recommended you review it with your health care provider or a genetics professional.
Last updated on 05-01-20
Only 3% of individuals with a known genetic susceptibility to celiac disease actually develop the disease because other factors play a significant role in the development of the condition. Environmental factors and changes in other genes (which are not yet well-understood) influence the development of this complex disease.
Last updated on 05-01-20
The long-term outlook (prognosis) for people with celiac disease can vary because some people have no symptoms, while others have severe malabsorption features. Overall, people with untreated or unresponsive celiac disease have increased early mortality compared to the general population. Without diagnosis and treatment, celiac disease is ultimately fatal in 10 to 30% of people. Currently this outcome is rare, as most people do well if they avoid gluten.
Following a gluten-free diet heals the damage to the intestines and prevents further damage. This healing most often occurs within 3-6 months in children and may take 2-3 years in adults. In rare cases there can be long-term damage to the lining of the intestines before the diagnosis is made. Strictly adhering to a gluten-free diet also significantly decreases the risk of cancer.
Last updated on 05-01-20
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