Genetic differences in HLA phenotypes were studied in coeliac disease to investigate why some patients do not react with mucosal damage after gluten challenge. Forty five children with coeliac disease and 16 with transitory gluten intolerance were typed; 76 subjects served as controls. HLA phenotypes in children with coeliac disease had significantly higher proportions of DR3/X and DR5/7 than controls (48-8% v 11-8% and 26-7% v 5.3%). Children with transitory gluten intolerance had lower DR3/X (43.8%) than children with coeliac disease and there were no DR5/7 phenotypes.Further analysis of similarly well defined cases might show whether genetic differences in the DR3/X and DR5/7 phenotypes can serve as a marker for the permanence of gluten intolerance. (Arch Dis Child 1995; 72: 29-32)

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ABSTRACT. The intent of this statement is to inform practitioners about the special health care needs and vulnerabilities of immigrant children and their families and to suggest clinical approaches to various aspects of their care. Immigrant children and their families, a large and diverse population group, have numerous risks to physical health and functioning and may be unfamiliar with our health care services. They often face many barriers to care, and their special risks and needs may not be familiar or readily apparent to many health care providers. Recently enacted federal welfare and immigration reform measures may increase the vulnerability of this population by limiting its access to health and social services. For multiple ethical and medical reasons, the American Academy of Pediatrics has historically opposed, and continues to oppose, denying needed services to any child residing within the borders of the United States.