Screening of diabetic children for coeliac disease with antigliadin antibodies and HLA typing.

Barera, Graziano; Bianchi, Cesare; Calisti, L; Cerutti, Fránco; Dammacco, Franco; Frezza, E; Illeni, Maria Teresa; Mistura, L; Pocecco, M; Prisco, F

doi:10.1136/adc.66.4.491

Cited by 87 publications

(56 citation statements)

References 33 publications

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“…It is well known that the prevalence of coeliac disease among patients with Type I diabetes is higher than expected, with rates of 2 to 8 % [8,9]. The present findings are in line with other epidemiological studies and show that the prevalence of coeliac disease is significantly greater in diabetic patients (5.7 %) than in both first-degree relatives (1.9 %) and healthy control subjects (0.25 %).…”

Section: Discussionsupporting

confidence: 82%

“…This should encourage policymakers to consider introducing an easy-touse screening programme for diabetic patients and their relatives into everyday clinical practice, in order to prevent coeliac-associated symptoms and the onset of additional, more serious auto-immune disorders. netic background only [8,10,11] or, as has recently been proposed, to the fact that long-term exposure to gluten could induce Type I diabetes and other autoimmune disorders in genetically predisposed subjects [12]. Most cases of coeliac disease associated with Type I diabetes do not present gastro-intestinal symptoms, despite the presence of the characteristic intestinal lesions and these cases would be missed without a screening programme [13].…”

mentioning

confidence: 99%

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Undiagnosed coeliac disease and risk of autoimmune disorders in subjects with Type I diabetes mellitus

et al. 2001

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AIMS/HYPOTHESIS: We tested the hypothesis that silent coeliac disease is more frequent than expected in both patients with Type I (insulin-dependent) diabetes mellitus and their first-degree relatives. We evaluated how the presence of other autoimmune disorders in diabetic patients and their first-degree relatives is related to silent, unrecognized coeliac disease. METHODS: Sera from 491 subjects with Type I diabetes, 824 relatives and 4,000 healthy control subjects were screened for anti-endomysial antibodies and all those subjects who tested positive for anti-endomysial antibodies underwent intestinal biopsy. RESULTS: We found that the prevalence of coeliac disease was 5.7 \% among the diabetic patients and 1.9 \% among the relatives, values significantly higher than those found among the control subjects (p < 0.0001; p < 0.001). The prevalence of autoimmune disorders in diabetic patients with coeliac disease was significantly higher than in subjects with Type I diabetes alone (p < 0.0001). The prevalence of autoimmune disorders in the relatives with coeliac disease was significantly higher than in those who tested negative for anti-endomysial antibodies (p = 0.01). CONCLUSION/INTERPRETATION: This report provides further confirmation of the high prevalence of undiagnosed coeliac disease among diabetic patients and their relatives. This interesting new finding is the increased presence of other autoimmune diseases in these patients, as well as in their relatives with a delayed diagnosis for coeliac disease. Patients newly diagnosed with coeliac disease showed excellent compliance with the gluten-free diet. This should encourage policymakers to consider introducing an easy-to-use screening programme for diabetic patients and their relatives into everyday clinical practice, in order to prevent coeliac-associated symptoms and the onset of additional, more serious auto-immune disorders

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Section: Discussionsupporting

confidence: 82%

mentioning

confidence: 99%

Undiagnosed coeliac disease and risk of autoimmune disorders in subjects with Type I diabetes mellitus

et al. 2001

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“…In the present study, patients with celiac disease had a significantly earlier onset of diabetes compared with diabetic subjects without celiac disease (Table 1). This observation is in agreement with some (3,18,19) but not all (20 -22) previous studies. In a recent Italian multicenter study in which 4,322 young patients with type 1 diabetes were investigated, a threefold higher risk for celiac disease was found in children Ͻ4 years old at the onset of diabetes than in those Ͼ9 years old (2).…”

Section: Statisticssupporting

confidence: 82%

Clinical Benefit of a Gluten-Free Diet in Type 1 Diabetic Children With Screening-Detected Celiac Disease

et al. 2006

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OBJECTIVE—This study was performed to 1) determine the prevalence of celiac disease in Danish children with type 1 diabetes and 2) estimate the clinical effects of a gluten-free diet (GFD) in patients with diabetes and celiac disease. RESEARCH DESIGN AND METHODS—In a region comprising 24% of the Danish population, all patients <16 years old with type 1 diabetes were identified and 269 (89%) were included in the study. The diagnosis of celiac disease was suspected in patients with endomysium and tissue transglutaminase antibodies in serum and confirmed by intestinal biopsy. Patients with celiac disease were followed for 2 years while consuming a GFD. RESULTS—In 28 of 33 patients with celiac antibodies, an intestinal biopsy showed villous atrophy. In 5 patients, celiac disease had been diagnosed previously, giving an overall prevalence of 12.3% (95% CI 8.6–16.9). Patients with celiac disease had a lower SD score (SDS) for height (P < 0.001) and weight (P = 0.002) than patients without celiac disease and were significantly younger at diabetes onset (P = 0.041). A GFD was obtained in 31 of 33 patients. After 2 years of follow-up, there was an increase in weight SDS (P = 0.006) and in children <14 years old an increase in height SDS (P = 0.036). An increase in hemoglobin (P = 0.002) and serum ferritin (P = 0.020) was found, whereas HbA1c remained unchanged (P = 0.311) during follow-up. CONCLUSIONS—This population-based study showed the highest reported prevalence of celiac disease in type 1 diabetes in Europe. Patients with celiac disease showed clinical improvements with a GFD. We recommend screening for celiac disease in all children with type 1 diabetes.

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“…A prevalência da DC em pacientes com DM1 encontrada foi semelhante à relatada em pesquisas anteriores (1,4,16 Em função do custo maior do exame ATGT e da associação da DC com a imunodeficiência de IgA (18), o anticorpo antigliadina apresenta-se como uma boa opção para a triagem da DC.…”

Section: Discussionunclassified

Estudo da prevalência da doença celíaca em crianças e adolescentes com diabetes melito tipo 1: resultado de 10 anos de acompanhamento

Gonçalves

Silva

Tanure

et al. 2013

Arq Bras Endocrinol Metab

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OBJETIVO: Avaliar a prevalência da doença celíaca (DC) em crianças e adolescentes com diabetes melito tipo 1 (DM1) atendidos no Serviço de Endocrinologia Pediátrica do Hospital das Clínicas da Universidade Federal de Minas Gerais. SUJEITOS E MÉTODOS: Incluídos no estudo crianças e adolescentes com diagnóstico prévio de DM1 acompanhadas no serviço no período de março de 1999 a abril de 2009, com idades entre zero e 18 anos. Todos foram rastreados para DC na primeira consulta e anualmente. A investigação foi realizada por meio da dosagem dos anticorpos da classe IgA (AGAA) e IgG (AGAG) antigliadina. Os pacientes com AGAA e/ou AGAG acima de duas vezes o valor de referência foram submetidos à biópsia intestinal. RESULTADOS: Foram excluídos 21 pacientes do total inicial de 384. Destes, 50 tiveram a sorologia positiva e 29 foram submetidos à biópsia intestinal. A prevalência encontrada foi de 3,1%. CONCLUSÃO: O rastreamento periódico da DC nos pacientes diabéticos deve ser encorajado, dada sua alta prevalência.

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Screening of diabetic children for coeliac disease with antigliadin antibodies and HLA typing.

Abstract: IgA and IgG antigliadin antibodies were measured in 498 patients with insulin dependent diabetes mellitus and no history of intestinal malabsorption. Thirty patients had abnormal concentrations of antigliadin anti-

Cited by 87 publications

References 33 publications

Undiagnosed coeliac disease and risk of autoimmune disorders in subjects with Type I diabetes mellitus

Undiagnosed coeliac disease and risk of autoimmune disorders in subjects with Type I diabetes mellitus

Clinical Benefit of a Gluten-Free Diet in Type 1 Diabetic Children With Screening-Detected Celiac Disease

Estudo da prevalência da doença celíaca em crianças e adolescentes com diabetes melito tipo 1: resultado de 10 anos de acompanhamento

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