Estudio de enfermedad celíaca en pacientes adultos con diabetes mellitus de tipo 1

Arregui, Miren Vicuña; Urmeneta, José Manuel Zozaya; Esteban, Juan Pablo Martínez de; Martínez, David Carral; Arribas, José Javier Pineda; Llenas, Lluís Forga; Virseda, José María Martínez Peñuela; Gutiérrez, Cristina Rodríguez; Torre, Edelmiro Menéndez; Pérez, Francisco Javier Jiménez; Echezuri, Eduardo Layana

doi:10.1016/j.gastrohep.2009.07.010

Cited by 9 publications

(4 citation statements)

References 32 publications

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“…Using HLA typing as a screening strategy in DM1 patients allowed us to diagnose 6 cases with definite CD, which represented a 3% prevalence of CD in this group. Even though this prevalence is 3 times higher than that found in the general population, it is similar to the one found by our group and other researchers when using antibody testing for CD screening only [ 14 , 20 , 21 ]. Therefore, HLA typing in DM1 cases does not seem to have an additional value for the screening of CD in these patients.…”

Section: Discussionsupporting

confidence: 89%

“…Since 4 of the 6 patients diagnosed with definite CD showed positive antibodies, HLA typing in our study was only useful in diagnosing 2 patients with CD and negative serology. It should be noted that our DM1 patient sample came from the same population as the patient sample from our previous study, in which CD screening was performed by measuring antibodies [ 14 ]; thus previously diagnosed CD patients were excluded. This might therefore mean that the prevalence of CD in our DM1 population was slightly greater than the prevalence that has been estimated in each of our studies separately.…”

Section: Discussionmentioning

confidence: 99%

“…It was calculated that a sample of 142 individuals would be needed to estimate the proportion of patients with CD among those diagnosed with DM1 (1056 DM1 patients, estimated CD prevalence of 4% in this group) with an accuracy of ±3%. Based on a previous study performed by our group [ 14 ], we considered a 70% participation acceptance rate; thus, we aimed to include 200 patients. These subjects were selected consecutively according to their order of attendance at the endocrinology consulting room.…”

Section: Methodsmentioning

confidence: 99%

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The role of flow cytometry in celiac disease screening using human leukocyte antigen in adult patients with type 1 diabetes mellitus

Arregui

Urmeneta

Brito

et al. 2016

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BackgroundPatients with type 1 diabetes mellitus (DM1) have an increased risk of celiac disease (CD). Since CD can be seronegative, more sensible tests for detection are needed. In seronegative patients, CD diagnosis may be difficult because of a lack of specificity. Flow cytometry analysis of lymphocyte populations can be useful in this situation. We aimed to study the prevalence of CD in adult DM1 using human leukocyte antigen (HLA) compatibility-based screening. A secondary goal was to study the role of flow cytometry as a complementary tool in these patients.MethodsWe selected 200 patients with DM1, of whom 190 (95%) had HLA DQ2, DQ8 or both. Of these, 136 agreed to participate and provided epidemiological data. All patients underwent blood tests and gastroscopy.ResultsSixteen patients had a histology consistent with CD. After ruling out other diagnoses, 6 patients were diagnosed with CD, 2 of whom had negative antibodies. All were DQ2.5 homozygous, with a CD prevalence of 9.8% in this group. In the flow cytometry analysis of duodenal biopsy samples, when we compared all non-CD with CD patients, we found that the γ/δ intraepithelial lymphocyte (IEL) percentage was significantly higher and the CD3 negative IEL percentage significantly lower in the CD group. We found similar results when we compared only those with histological lesions.ConclusionsScreening of CD in patients with DM1 by HLA detects only 1% of seronegative patients with CD. DQ2.5 homozygous patients are at most risk of developing CD. The study of lymphocyte populations in the duodenal biopsy by flow cytometry discriminates patients with CD from those without CD with high sensitivity and specificity.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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The role of flow cytometry in celiac disease screening using human leukocyte antigen in adult patients with type 1 diabetes mellitus

Arregui

Urmeneta

Brito

et al. 2016

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“…Dans notre étude, nous avons trouvé une séroprévalence des AAG et/ou AtTG de 29% chez les patients diabétiques de type 1. Ce chiffre est très élevée par rapport aux données de la littérature qui montrent que la prévalence de la MC dans le DT1 est 20 fois plus fréquente que dans la population générale et qu'elle varie en fonction des populations En Europe la prévalence sérologique varie entre 3.6% et 13.4% [7–10]. En Amérique elle est entre 8 et 11,8% [11, 12] et au Maghreb entre 4 et 16% [13–15].…”

Section: Discussionunclassified

Dépistage sérologique de la maladie cœliaque chez des patients marocains atteints de diabète type 1

Bourhanbour¹,

Ouadghiri²,

Benseffaj³

et al. 2016

Pan Afr Med J

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La maladie cœliaque (MC) est l'une des maladies auto-immunes les plus fréquemment associées au diabète de type 1 (DT1). La prévalence de MC dans DT1 varie de 3 à 6%. La présentation clinique de MC dans DT1 est classé comme asymptomatiques dans environ la moitié des cas. L'objectif de notre étude est de déterminer la fréquence des auto-anticorps anti-transglutaminase tissulaire (AtTG) et anti-gliadines (AAG) chez les patients diabétiques de type 1 dans le but de recommander une éventuelle biopsie jéjunale et d'instaurer un régime sans gluten précocement avant l'installation des signes cliniques et des complications de la maladie cœliaque. Les sujets inclus dans cette étude sont des patients atteints de DT1 non traités pour la MC et qui ne présentent pas de signes en faveur de cette pathologie. La détection des AtTG de classe IgG et IgA et AAG classe IgG et IgA a été réalisée par technologie Luminex. Nous avons inclus 31 patients. Il s'agit de 16 hommes et 15 femmes. Les AAG de classe IgA étaient positifs chez 4(13%) patients et chez 7(22,5%) patients pour les IgG. Les AtTG de classe IgA étaient positifs chez 3(10%) patients et chez une patiente (3%) pour les IgG. Dans notre étude l'association du diabète type 1 et des marqueurs biologiques de la MC n'est pas rare d'où l'intérêt de son dépistage systématique chez des diabétiques de type 1. Le diagnostic de cette forme atypique et silencieuse de la MC est important compte tenu du risque de complications sérieuses à type de malabsorption et de cancers digestifs.

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Prevalence of IgA antitissue transglutaminase antibodies in children with type 1 diabetes mellitus

Samaşcă

Ilie

Butnariu

et al. 2011

J. Clin. Lab. Anal.

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Estudio de enfermedad celíaca en pacientes adultos con diabetes mellitus de tipo 1

Cited by 9 publications

References 32 publications

The role of flow cytometry in celiac disease screening using human leukocyte antigen in adult patients with type 1 diabetes mellitus

The role of flow cytometry in celiac disease screening using human leukocyte antigen in adult patients with type 1 diabetes mellitus

Dépistage sérologique de la maladie cœliaque chez des patients marocains atteints de diabète type 1

Prevalence of IgA antitissue transglutaminase antibodies in children with type 1 diabetes mellitus

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