Coexistance of celiac disease and type 1 diabetes

Szaflarska-Popławska, Anna

doi:10.5114/pg.2014.40844

Cited by 16 publications

(20 citation statements)

References 45 publications

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“…7 Our results analyze this relationship in a prospective manner at an earlier stage when autoantibodies to the respective diseases first develop. These autoantibodies are highly predictive of clinical disease and may be encountered more frequently as genetic screening and personalized medicine become more widespread.…”

Section: Discussionmentioning

confidence: 99%

“…It has been widely supposed that HLA antigen explains the overlap 7,12,13 because similar HLA-DR-DQ genotypes strongly predispose to both diseases. However, this did not appear to be the case.…”

Section: Discussionmentioning

confidence: 99%

“…This ranged from 2.5% to 16.4% (5.7% overall) in 23 studies worldwide, 7 much greater than background CD rates. Conversely, studies of subsequent T1D in children with previous CD also revealed significantly more T1D than in non-CD controls.…”

mentioning

confidence: 89%

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Co-occurrence of Type 1 Diabetes and Celiac Disease Autoimmunity

et al. 2017

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BACKGROUND AND OBJECTIVES Few birth cohorts have prospectively followed development of type 1 diabetes (T1D) and celiac disease (CD) autoimmunities to determine timing, extent of co-occurrence, and associated genetic and demographic factors. METHODS In this prospective birth cohort study, 8676 children at high genetic risk of both diseases were enrolled and 5891 analyzed in median follow-up of 66 months. Along with demographic factors and HLA-DR-DQ, genotypes for HLA-DPB1 and 5 non-HLA loci conferring risk of both T1D and CD were analyzed. RESULTS Development of persistent islet autoantibodies (IAs) and tissue transglutaminase autoantibodies (tTGAs), as well as each clinical disease, was evaluated quarterly from 3 to 48 months of age and semiannually thereafter. IAs alone appeared in 367, tTGAs alone in 808, and both in 90 children. Co-occurrence significantly exceeded the expected rate. IAs usually, but not always, appeared earlier than tTGAs. IAs preceding tTGAs was associated with increasing risk of tTGAs (hazard ratio [HR]: 1.48; 95% confidence interval [CI]: 1.15–1.91). After adjusting for country, sex, family history, and all other genetic loci, significantly greater co-occurrence was observed in children with a T1D family history (HR: 2.80), HLA-DR3/4 (HR: 1.94) and single-nucleotide polymorphism rs3184504 at SH2B3 (HR: 1.53). However, observed co-occurrence was not fully accounted for by all analyzed factors. CONCLUSIONS In early childhood, T1D autoimmunity usually precedes CD autoimmunity. Preceding IAs significantly increases the risk of subsequent tTGAs. Co-occurrence is greater than explained by demographic factors and extensive genetic risk loci, indicating that shared environmental or pathophysiological mechanisms may contribute to the increased risk.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Co-occurrence of Type 1 Diabetes and Celiac Disease Autoimmunity

et al. 2017

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“…According to current data, the prevalence of CD is 5–7 times higher in diabetic patients compared to general population. The percentage of diabetic children with histopathologically confirmed CD varies from 2.4% in Finland to 16.4% in Algeria [ 14 ]. In T1DM patients with CD, typical gastrointestinal findings such as diarrhea and abdominal distention are rarely seen, whether atypical findings such as sideropenic anemia, short stature or delayed puberty are more commonly observed [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Autoimmunity and intestinal colonization by Candida albicans in patients with type 1 diabetes at the time of the diagnosis

et al. 2018

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Purpose Type 1 diabetes mellitus (T1DM) is a chronic and immune-mediated disease, which is characterized by the progressive destruction of pancreatic beta cells. T1DM precipitates in genetically susceptible individuals through environmental factors. In this study, we aimed to evaluate the impact of autoimmunity and intestinal colonization of Candida albicans on the development of T1DM.Methods Forty-two patients newly diagnosed with T1DM and 42 healthy subjects were included in this monocentric study. The basic and clinical characteristics of the patients were recorded. T1DM-, thyroid-, and celiac-associated antibodies were evaluated. Stool cultures for C. albicans were performed to assess whether or not gut integrity was impaired in patients with T1DM.Results The evaluation of T1DM- and thyroid-associated antibodies showed that the prevalences of islet cell antibodies and antithyroperoxidase positivity were higher in the study patients than in the patients in the control group. Furthermore, the direct examination and culture of fresh stool samples revealed that 50% of the patients with T1DM and 23.8% of the control subjects had fungi (C. albicans).Conclusion Through this study, we suggest that the presence of intestinal C. albicans colonization at the time of the diagnosis of T1DM may indicate impairment of normal intestinal microbiota. We also suggest that there may be a tendency of T1DM in patients with a high prevalence of intestinal C. albicans.

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“…These facts accounted for the high prevalence of abdominal pain in group DM1, as was previously reported in some studies [ 10,21,23 ]. Clinical symptoms of CelD are estimated to occur in 50% of individuals with DM1, with abdominal pain in 16% of the cases [ 19 ]. Reduced intestinal muscle tone, which occurs in individuals with DS, and the possible occurrence of previously undiagnosed CelD may contribute to the higher frequency of constipation and flatulence in this group of patients [ 13,15 ].…”

Section: Discussionmentioning

confidence: 99%

The celiac iceberg: from the clinical spectrum to serology and histopathology in children and adolescents with type 1 diabetes mellitus and Down syndrome

Gomes¹,

Maia²,

Arrais³

et al. 2015

Scandinavian Journal of Gastroenterology

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Objective: The objective of this study is to investigate the occurrence of gastrointestinal (GI) and extraintestinal symptoms in children and adolescents with type 1 diabetes mellitus (DM1) and Down syndrome (DS) and their association with specific antibodies and histopathology of celiac disease (CelD), representing its clinical forms in the iceberg. Material and methods: Cross-sectional study (November 2009–December 2012) conducted at an outpatient care facility in Northeast Brazil including patients [DM1 (n = 111); DS (n = 77)] aged 10 months–18 years old. Measurement of anti-endomysial (EmA) and anti-tissue transglutaminase (anti-tTG) IgA antibodies was performed, as was that of anti-tTG-IgG in the cases with low serum IgA. The patients with antibody positivity were subjected to small intestine biopsy. Results: GI symptoms occurred in 53.7% of the sample, extraintestinal symptoms in 4.3%, and antibody positivity in 28.2% (n = 53). Of those who underwent biopsy (n = 40), histopathological findings of CelD were found in 37.5% [DM1 = 5/111 (4.5%), DS = 10/77 (13.0%)]. GI symptoms were associated with antibody positivity, but not with the histopathology. The GI (32.5%), silent (5.0%), and potential (62.5%) forms of disease were detected. Conclusions: The prevalence of GI symptoms was high in groups DM1 and DS, and the occurrence of such symptoms was associated with antibody positivity. The lack of association between the symptoms and histopatholological findings points to the inconsistency of the former as indicators of CelD. Although the GI form predominated among the cases with active CelD, its contribution to the celiac iceberg was smaller compared with the potential form, which determined the large and submerged base of the iceberg representing the high-risk groups investigated.

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Coexistance of celiac disease and type 1 diabetes

Cited by 16 publications

References 45 publications

Co-occurrence of Type 1 Diabetes and Celiac Disease Autoimmunity

Co-occurrence of Type 1 Diabetes and Celiac Disease Autoimmunity

Autoimmunity and intestinal colonization by Candida albicans in patients with type 1 diabetes at the time of the diagnosis

The celiac iceberg: from the clinical spectrum to serology and histopathology in children and adolescents with type 1 diabetes mellitus and Down syndrome

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