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Celiac Disease and HLADQ2/DQ8 Genotypes in Severe Acute Malnutrition: A Hospital-Based Study
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DOI：10.1007/s13312-026-00297-5.png)
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Abstract
En 中文
Objectives To determine the proportion of celiac disease (CD) among children with severe acute malnutrition (SAM) and to evaluate the distribution and association of HLA-DQ2/DQ8 genotypes in affected children. Methods Children aged 6-59 months diagnosed with SAM were assessed for inclusion. Those with secondary causes of SAM like underlying chronic illnesses like congenital heart disease, renal disease, or immunodeficiency were excluded. All participants were tested for tissue transglutaminase (tTG) immunoglobulin A serology, endoscopic biopsy of duodenum and HLA DQ2/DQ8 genotyping. tTG IgA serology positive and histopathology compatible (Modified Marsh grade >= II) cases were grouped as group A (SAM with CD). Rest of the cases were grouped as group B (SAM without CD). Results Out of 140 children with SAM, 20 with secondary causes of malnutrition were excluded. 40 out of 140 participants (28.57%) were tTG IgA positive with duodenal biopsy confirmatory of CD (group A). HLA-DQ2/DQ8 positivity was observed in 95% in group A and 57% of group B (P < 0.001). The most frequent genotype was HLA-DQ2.5 (67.5% in group A, 35% in group B; OR = 3.86, 95% CI 1.72-8.63). Conclusion A substantial proportion of children with SAM have undiagnosed CD with HLA-DQ2.5 genotype being the most common genotype.
Keywords:
Anti-tTG
Genetic predisposition
Gluten enteropathy
Growth failure
Marsh grading