-Context -Celiac disease, one of the best-known autoimmune human leukocyte antigen-dependent disorders, has a relatively increased prevalence in first-degree relatives. Objective -To determine the prevalence of celiac disease in siblings of patients with confirmed celiac disease. Methods -Siblings of confirmed celiac disease patients in our center were identified and enrolled in this study. Their serum immunoglobulin A and tissue transglutaminase antibody-enzyme-linked immunosorbent assay (anti-tissue transglutaminase, immunoglobulin A, and immunoglobulin G) were measured and multiple endoscopic duodenal biopsy specimens were obtained with parental consensus. Celiac disease was confirmed by observation of characteristic histological changes. Results -A total of 49 children (male, 29; female, 20; age, 2-16 years) with confirmed celiac disease in a pediatric gastroenterology ward were studied from 1999 to 2006. We found 30 siblings (female, 16) all shared in both parents. The only measurement available was for immunoglobulin A tissue transglutaminase antibody. A duodenal biopsy was performed in all 30 siblings. Clinical findings such as abdominal pain, fatigue, growth retardation and diarrhea were found in 53.3% of the completely studied siblings, and positive serology without histological changes was identified in four cases. Both serology and biopsy (confirmed new cases) were positive in 2 of the 30 siblings. Conclusion -High prevalence of celiac disease among siblings of patients with confirmed celiac disease necessitates serologic screening (and confirmatory biopsy if indicated) in families having celiac disease. It is advantageous to diagnose the disease as soon as possible because early diagnosis and diet intervention may prevent serious complications such as growth retardation, short stature, chronic diarrhea, and malignancy.

Objectives To investigate an association between seasonal changes in temperature and the prevalence of congenital hypothyroidism (CH) in the Southwest of Iran. Methods A prospective two-year study conducted from March 2007 to March 2009 during the nationwide screening programme for CH in Ahvaz, the biggest city in southwest Iran. Blood samples were taken from almost all newborns by heel-stick and used in a thyroid-stimulating hormone (TSH)-enzyme-linked immunosorbent assay (ELISA). Serum thyroxine (T4) and TSH were measured if the ELISA-TSH was .5 mIU/L (suspicious cases). Infants were considered to have CH with T4 ,6.0 mg/dL and TSH . 10 mIU/L, or with normal T4 values and persistent high TSH values for .2 months (subclinical hypothyroidism). Date of birth and sex were recorded. Detailed temperature data were obtained from the meteorological organization. The relationship between the monthly incidence of CH and the average monthly temperature was investigated.Results From 47,075 (50.92% male) newborns, 1131 were referred (recall rate ¼ 2.4%) and 142 infants (51.4% male) were confirmed to have CH. The seasonal distribution of CH cases was 32.4% in the warm period and 67.6% in the cold period of the year (19%, 13.4%, 32.4% and 35.2% in spring, summer, fall and winter, respectively; P ¼ 0.001). A statistical difference was seen between mid-summer (2.8%, warmest time) and early winter (15.5%, coldest time). The above-mentioned difference was the same for suspicious individuals (P , 0.001). The odds of being affected were increased by 4% for each fall of 18C. Conclusion The prevalence of CH has a significant negative correlation with the temperature in the tropical area of Iran.

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