Authors:
A. Torío Ruiz (Albacete, ES)
O. Montes-Ares (Murcia, ES)
I. Bernardo (Logroño, ES)
M. Muro (Murcia, ES)
J. Ocejo-Vinyals (Santander, ES)
D. Planelles (Valencia, ES)
R. Gonzalez (Córdoba, ES)
C. Cabrera (Málaga, ES)
E. Palou (Barcelona, ES)
A. Franco (La Laguna, ES)
M. Alcala (Badajoz, ES)
A. Nieto (Cádiz, ES)
M. Fernandez-Arquero (Madrid, ES)
M. De Juan (Donostia-San Sebastian, ES)
R. Lopez-Hernandez (Las Palmas, ES)
A. Arrieta (Baracaldo, ES)
J. Caro (Barcelona, ES)
C. Abad-Molina (Sevilla, ES)
C. Vilches (Madrid, ES)
M. Castro (Madrid, ES)
M. Abad-Alastruey (Santiago de Compostela, ES)
C. Moreno (Pamplona, ES)
E. Balmaseda (Albacete, ES)
D. Gil-Ortega (Murcia, ES)
D. González-Santana (Las Palmas, ES)
M. Vicente (Albacete, ES)
F. Gil-Ares (Getafe, ES)
G. Ercilla (Barcelona, ES)
E. Vergara (Badajoz, ES)
M. González-Escribano (Sevilla, ES)
J. Ontañón (Albacete, ES)
Different strategies are used in commercial kits to perform HLA typing in patients with celiac disease symptoms (complete HLA-DQ typing or only alleles associated with the disease). Also, different reports are used to communicate the typing results. The Spanish Society of Immunology sent a survey about the typing and report strategies to 35 HLA laboratories in Spain, and 21 were completed. Regarding the typing strategy, 20 laboratories report that besides DQB* they also perform DQA1 typing, while 14 laboratories also perform DRB1 typing. Regarding the kind of reports, 20 laboratories report complete typing. Most of the laboratories do not report risk graded by haplotypes. Half of the laboratories add comments when the patient does not carry any risk haplotype. Regarding the different haplotypes, there is no consensus among the participating laboratories about the risks of DRB1*07-DQB1*02:02-DQA1*02:01 (homozygous or heterozygous), and DRB1*11/12-DQB1*03:01-DQA1*05:05 haplotypes. In a second phase, another survey was sent to a series of 14 clinicians to find out when HLA typing was requested, and their preferences about the results report. In these questionnaires we observed different strategies between paediatricians (requiring HLA in every patient with celiac disease suspicion) and gastroenterologists (only in doubtful patients or for confirmation). 78% of clinicians consider that HLA typing is useful to rule out the disease, while 45% consider that is also useful to confirm it. All of them expressed their wish to have information about the risk inside the report. Also, they reflect doubts about the typing reports, and its complex terminology and claim the importance of reporting the serological equivalence (DQ2-DQ8). In conclusion, there is no consensus among the HLA laboratories on the way they report the HLA results in Celiac Disease. The clinicians claim for an interpretation of the HLA results.