Prevalence and HLA Genotypes of Coeliac disease among Sudanese children with Type1 Diabetes Mellitus

Abstract

Coeliac disease (CD) is a permanent intolerance to gluten that results in damage to the mucosa of the small intestine. This damage consists of mucosal inflammation and loss of absorptive surface area and is manifested by a broad spectrum of symptoms and nutritional deficiencies. The immune mediated damage to small bowel mucosa triggered by an immune response to the gliadin fraction of gluten, a component of wheat, barley and oats. This study was performed to determine the Prevalence of Coeliac disease among Sudanese children with type 1 diabetes mellitus(T1D)using ELISA technique) , to evaluate how well the (tag SNP) results correlate with HLA genotypes(using PCR techniques), to determine the homozygosity and heterozygosity for a risk haplotypes, and todetrmine which HLA haplotypes are involved in an increase risk of CD among Sudanese .The tTG-IgA results showed an occurrence of 26out of 373 T1D patients (6.97%) compared to 2% among controls. CD was confirmed by biopsy sample from the duodenum of 9 out of 17(53%) of T1D patients ,and one out of the controls who showed villous atrophy. The HLA-DQB1 typing showed Ratio of DQ2+ to the DQ2- was 6:1 folds in CD+ve group while it was , 7:1 folds in T1D+ve CD group . The six SNPs showed specificity (94-99%) in detecting of all haplotypes DQ2 (D2.5&DQ2.2),DQ7,and DQ8.And high sensitivity (75-83%) for haplotypes DQ2 (D2.5&DQ2.2),DQ8,However the sensitivity (37%) was much lower for DQ7.