A Study of the Magnitude of Celiac Disease in Siblings of Children (1–18 Years) with Confirmed Celiac Cases

Background: Celiac disease (CD) is chronic autoimmune disorder triggered by ingestion of gluten in genetically predisposed individuals. It has a wide spectrum of clinical presentations, ranging from classical gastrointestinal symptoms to silent or atypical forms. CD is strongly associated with genetic factors, particularly HLA-DQ2 and HLA-DQ8 haplotypes, and is more common among first-degree relatives of affected individuals. This study focuses on magnitude of CD among siblings of confirmed paediatric celiac patients. Objective: To determine magnitude of celiac disease in siblings of children diagnosed with CD at tertiary care center in Rajasthan and to assess clinical presentation, serological, and histopathological characteristics in this high-risk group. Methods: This hospital-based, cross-sectional study was conducted at Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India from May 2021 to May 2022. Fifty siblings of 44 biopsy-confirmed CD patients were recruited. All participants underwent serological testing for anti-tissue transglutaminase (tTG-IgA) antibodies, and those with positive serology were subjected to upper gastrointestinal endoscopy and biopsy. Histopathological examination using Modified Marsh Classification was performed to confirm deign. Results: prevalence of celiac disease among siblings was found to be 14%, with 7out of 50participants testing positive for tTG-IgA. Among these, 57%were female, and most were asymptomatic or presented with nonclassical symptoms such as abdominal pain, short stature, and pallor. Endoscopic and histopathological examination confirmed diagnosis of CD in all serologically positive cases, with Marsh Grade 3a and 3b being most common findings. Conclusion: Study highlights a significant prevalence of CD among siblings of affected individuals, underscoring importance of targeted screening in this high-risk group. Early diagnosis and intervention, particularly in asymptomatic or non-classical cases, can prevent long-term complications. Routine screening for CD in siblings of confirmed cases should be recommended to ensure timely diagnosis and management.