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Early Developing Celiac Disease in Children With Cerebral Palsy

Stenberg, Reidun*; Kaukinen, Katri; Bengtsson, Mats; Lindberg, Eva*; Dahle, Charlotte

Journal of Pediatric Gastroenterology and Nutrition: December 2011 - Volume 53 - Issue 6 - p 674–678
doi: 10.1097/MPG.0b013e318229889d
Original Articles: Gastroenterology

Objectives: We have reported on increased levels of antibodies against gliadin and/or transglutaminase 2 (TG2) in children with cerebral palsy (CP) but without having increased prevalence of celiac disease (CD). The aim of the present study was to evaluate whether these children have mucosal signs of early developing CD, human leukocyte antigen (HLA)-DQ2/DQ8, and antibodies against deamidated gliadin peptides (DGP).

Patients and Methods: Stored blood samples from 16 children with CP were analyzed regarding HLA-DQ2/DQ8 and anti-DGP antibodies. HLA-DQ2/DQ8 were analyzed by polymerase chain reaction sequence-specific oligonucleotide probes. Anti-DGP antibodies were analyzed with enzyme-linked immunosorbent assay. Small-bowel biopsies from 15 of these children were available for immunohistochemistry regarding IgA colocalized with TG2, densities of α/β+ and γ/δ+ intraepithelial lymphocytes.

Results: Mucosal immunoglobulin A (IgA) deposits colocalized with TG2 were found in the small-bowel biopsy from 1 patient with serum IgA-class anti-TG2 antibodies, HLA-DQ2, and gastrointestinal complaints. Another 2 children had slightly increased numbers of mucosal α/β+ and/or γ/δ+ intraepithelial lymphocytes. In total, 10 of 16 children were HLA-DQ2 and/or DQ8-positive. Anti-DGP antibodies were detected in sera from 4 of 16 children.

Conclusions: In the present study, 1 child with CP had IgA colocalizing with TG2 in the small-bowel mucosa, suggesting CD at an early stage. Although the majority of children with CP and elevated levels of CD-related seromarkers are HLA-DQ2 and/or DQ8-positive, they have neither classical nor early developing CD.

*Department of Paediatrics, Örebro University Hospital, Örebro, Sweden

Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, University of Tampere, Tampere, Finland

Department of Clinical Immunology, University Hospital and Uppsala University, Uppsala, Sweden.

Address correspondence and reprint requests to Reidun Stenberg, MD, Department of Paediatrics, University Hospital, 70185 Örebro, Sweden (e-mail:

Received 3 February, 2011

Accepted 10 May, 2011

The work was supported by grants from the Research Committee of Örebro County Council and Centre for Rehabilitation Research, Örebro County Council.

The authors report no conflicts of interest.

Copyright 2011 by ESPGHAN and NASPGHAN