Serum prevalence of celiac disease in children and adolescents with type 1 diabetes mellitus

Araújo, Jacqueline; Silva, Gisélia Alves Pontes da; Melo, Francisco Vicente Sales

doi:10.2223/jped.1478

Cited by 22 publications

(22 citation statements)

References 25 publications

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“…Patients with positive anti-TTG and normal intestinal biopsy in our study had a low positive anti-TTG level (20–67.8 U/ml) compared with the other 11 patients with higher anti-TTG and proven atrophic mucosa. The low sensitivity and specificity of low positive anti-TTG values for diagnosis of CD have also been observed in other studies [14,15,27]. Another finding that has also been observed by others [16], is that children with T1D, like other autoimmune diseases at risk of CD, could have transiently positive anti-TTG results at low values.…”

Section: Discussionsupporting

confidence: 75%

“…The potential for early reversal of abnormalities in indices of intestinal malabsorption (iron and calcium deficiencies) is one of the advantages for screening asymptomatic children for early detection of CD in T1D patients. The predominance of female gender among CD group in the present study has been observed in few studies [25,26], while other studies in different races have shown male predominance [27,28], which likely represents variability of genetic and environmental factors among different races.…”

Section: Discussionsupporting

confidence: 44%

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High prevalence of celiac disease among Saudi children with type 1 diabetes: a prospective cross-sectional study

et al. 2012

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BackgroundThere is lack of data on prevalence of celiac disease (CD) in children with type 1 diabetes (T1D) in Arabs in the Middle East. The present investigation aims to study the prevalence rate and clinical characteristics of CD among Saudi children with T1D using a combination of the most sensitive and specific screening serologic tests (anti- tissue transglutaminase antibodies IgA [anti-TTG] and ednomyseal antibodies [EMA]) and to determine the lower cut-off value of anti- anti-TTG level that best predicts CD in children with T1D.MethodsChildren with T1D following in diabetic clinic have been prospectively screened for presence of CD, over a two-year period (2008–2010), by doing anti-TTG, EMA, and total IgA. Children with positive anti-TTG titres (>50 U/ml) and/or EMA and children with persistently low positive anti-TTG titres (two readings 20–50 U/ml; within 6 months intervals) had upper endoscopy and 6 duodenal biopsies.ResultsOne hundred and six children with T1D have been screened for CD: age ranged between 8 months to 15.5 years (62 females). Nineteen children had positive anti-TTG and/or EMA, however only 12 children had biopsy proven CD (11.3%). Five of 12 had gastrointestinal symptoms (42%). Children with T1D and CD had significantly lower serum iron than children with T1D alone (8.5 μgm/L Vs 12.5 μgm/L; P = 0.014). The sensitivity and specificity of anti-TTG were 91.6% and 93.6%, with a positive and negative predictive value of 64.7% and 98.8%, respectively. Receiver operated characteristics analysis for the best cut-off value of anti-TTG level for diagnosis of CD was 63 units (sensitivity 100% and specificity 98.8%).ConclusionCD is highly prevalent among Saudi children with T1D. Anti-TTG titres more than 3 times the upper limit of normal has very high sensitivity and specificity for diagnosis of CD in T1D children.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionsupporting

confidence: 44%

High prevalence of celiac disease among Saudi children with type 1 diabetes: a prospective cross-sectional study

et al. 2012

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“…The only Brazilian study showing a higher prevalence (15.8%) of biopsy‐proven CD was based in a very small sample (19 patients with T1DM) . The same group carried out another study including 354 T1DM patients and found a prevalence of positive IgA‐tTG of 10.5%, but no information regarding the biopsy‐proven CD was mentioned . Recently, another study, conducted in the northeastern region of Brazil, found a prevalence of positive IgA‐tTG antibodies of 7.4%, but data of the biopsy were not informed as well …”

Section: Discussionmentioning

confidence: 99%

Prevalence of celiac disease in a large cohort of young patients with type 1 diabetes

et al. 2019

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Background Serological screening for celiac disease (CD) allows the identification of individuals genetically predisposed, as type 1 diabetes mellitus (T1DM). However, the diagnosis is confirmed by intestinal biopsy. The aim was to determine the prevalence of immunoglobulin‐A anti‐tissue transglutaminase antibodies (IgA‐tTG) and CD in a large cohort of young T1DM patients. Methods Screening for CD was randomly conducted in 881 T1DM by IgA‐tTG and total IgA. Individuals with positive antibodies were referred to endoscopy/duodenal biopsy. Results The age of the cohort at the screening was 14.3 ± 5.9 years and at T1DM onset was 7.9 ± 4.4 years. The prevalence of positive serology was 7.7%. Median IgA‐tTG levels were 117.7 U/mL (interquartile range [IQR] 35.7‐131.5 U/mL). Of the 62 duodenal biopsy, CD was diagnosed in 79.0%, yielding an overall prevalence of 5.6%. The mean age of CD patients was 15.6 ± 6.5 years and, at T1DM onset was 6.3 years (4.0‐9.9 years). The modified Marsh‐Oberhuber histological classification was 22.5% (3a), 36.7% (3b), and 40.8% (3c). In the biopsy‐proven patients, T1DM onset occurred at slightly younger ages (6.3 vs 9.7 years, P = 0.1947), gastrointestinal (GI) manifestations, predominantly abdominal pain and distension, were more prevalent (71.4% vs 38.5%, P = 0.027) and higher IgA‐tTG titers (128.0 vs 26.3 U/mL, P = 0.0003) were found than in those with negative‐biopsies. Conclusion Our results demonstrate the prevalence of 7.7% of IgA‐tTG and 5.6% of CD in T1DM patients in South Brazil and, emphasize the importance of the screening in high‐risk individuals. Furthermore, the presence of GI manifestations and higher IgA‐tTG titers strongly suggest the diagnosis of CD.

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“…The prevalence of CD in T1DM varies widely. It has ranged from 1.6% to 12.3% in Europe, 17–21 4.8% to 10.5% in South America, 22–23 4.9% to 6.2% in middle East; 24–25 and is highest in North Africa: 21.4% in Libya 26 and 16.4% in Algeria 27 . Among whites in North America, it ranges from 7–8% 14,28 while it is 2.9% among African Americans 29 .…”

Section: Discussionmentioning

confidence: 99%

Prevalence and clinical profile of celiac disease in type 1 diabetes mellitus in north India

Bhadada

Kochhar

Bhansali

et al. 2011

J of Gastro and Hepatol

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Serum prevalence of celiac disease in children and adolescents with type 1 diabetes mellitus

Cited by 22 publications

References 25 publications

High prevalence of celiac disease among Saudi children with type 1 diabetes: a prospective cross-sectional study

High prevalence of celiac disease among Saudi children with type 1 diabetes: a prospective cross-sectional study

Prevalence of celiac disease in a large cohort of young patients with type 1 diabetes

Prevalence and clinical profile of celiac disease in type 1 diabetes mellitus in north India

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