Celiac disease in insulin-dependent diabetes mellitus.
Jejunal biopsy was performed without selection in 110 of 201 children with insulin-dependent diabetes mellitus; serum reticulin antibody, antigliadin antibody by enzyme-linked immunosorbent assay, and serum IgA were studied in all 201 children. Seven children had severe jejunal villous atrophy, giving a prevalence of celiac disease of at least 3.5%. Of the serum tests used, antigliadin antibody with ELISA was the most sensitive. Four patients adhered to a gluten-free diet, and their jejunal structure became normal; three had subsequent gluten provocation, and the jejunal mucosa relapsed in every one. Six had HLA-B8 and -DR3 antigens, and one had B15 and -DR4 phenotypes. In most patients, a gluten-free diet had little effect on insulin dosage, urinary excretion of glucose, or serum level of hemoglobin A1.
Savilahti
E
E
Simell
O
O
Koskimies
S
S
Rilva
A
A
Akerblom
H K
HK
D000906:Antibodies / Q000276:immunology; D002446:Celiac Disease / Q000150:complications* / Q000178:diet therapy / Q000473:pathology; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D004035:Diet Therapy; D004797:Enzyme-Linked Immunosorbent Assay; D005903:Gliadin / Q000276:immunology; D006680:HLA Antigens / Q000235:genetics; D006801:Humans; D007583:Jejunum / Q000473:pathology; D010641:Phenotype; D012155:Reticulin / Q000276:immunology
D000906:Antibodies; D006680:HLA Antigens; D012155:Reticulin; D005903:Gliadin