Prevalence of coeliac disease in diabetic children and adolescents. A multicentre study.
Screening for coeliac disease (CD) with serum antigliadin antibodies (AGA) was performed in 1032 diabetic children and adolescents. In 8 children CD had been diagnosed before study entry. Of the remaining 1024 children, 33 had an elevated AGA titre in the first serum sample. On follow-up an elevated AGA titre was confirmed in only 17 of 31 patients. Nine of the repeatedly positive patients underwent jejunal biopsy, and CD was diagnosed in two asymptomatic patients; both were positive for IgG- and IgA-AGA. Among 10 AGA-positive patients in whom biopsies could not be performed, only 1 showed IgA-AGA and thus carried a high risk for CD. From our results we estimate a prevalence of CD in Swiss and German diabetic children between 1.1% and 1.3%. False-positive AGA titres occurred significantly more often in patients with diabetes duration of less than 1 year. AGA testing reached a specificity of 99% if performed at least 1 year after the onset of diabetes. Children suffering from both diabetes and CD showed a diabetes manifestation at a significantly younger age than non-coeliac patients, whereas CD tended to be diagnosed at a remarkably late age.
Koletzko
S
S
Kinderklinik der Universität, Düsseldorf, Federal Republic of Germany.
Bürgin-Wolff
A
A
Koletzko
B
B
Knapp
M
M
Burger
W
W
Grüneklee
D
D
Herz
G
G
Ruch
W
W
Thon
A
A
Wendel
U
U
D000293:Adolescent; D001706:Biopsy; D002446:Celiac Disease / Q000150:complications / Q000453:epidemiology*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D005903:Gliadin / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D008297:Male; D015337:Multicenter Studies as Topic; D012737:Sex Factors
D007070:Immunoglobulin A; D007074:Immunoglobulin G; D005903:Gliadin