Prevalence of IgA-antiendomysium and IgA-antigliadin autoantibodies at diagnosis of insulin-dependent diabetes mellitus in Swedish children and adolescents.
OBJECTIVE
This study was conducted to investigate the prevalence of celiac disease (CD) in children and adolescents at diagnosis of insulin-dependent diabetes mellitus (IDDM) before insulin treatment was started.


METHODS
At diagnosis of IDDM, and before treatment was started, 115 children and adolescents were screened for IgA- antiendomysium (EMA) and IgA-antigliadin antibodies (AGA). Those found to be EMA-positive and/or AGA-positive were investigated further with intestinal biopsy.


RESULTS
Of the 115 patients, 2 had known CD at diagnosis of IDDM; of the remainder of patients, 6% (7/113) were found to be EMA-positive and 9% (10/113) were found to have AGA levels above normal. Of the 6 patients who underwent biopsy, 5 manifested villous atrophy. In addition, 2 patients with high EMA and AGA antibody titers refused biopsy, and 4 patients with low EMA and/or AGA titers were found to have normal titers at control before biopsy decision.


CONCLUSIONS
Because the prevalence of CD at diagnosis of IDDM would seem to be 6% to 8%, screening for CD seems to be justified among patients with newly diagnosed IDDM.
Carlsson
A K
AK
Department of Pediatrics, University of Lund, University Hospital, Malmö, Sweden.
Axelsson
I E
IE
Borulf
S K
SK
Bredberg
A C
AC
Lindberg
B A
BA
Sjöberg
K G
KG
Ivarsson
S A
SA
D000293:Adolescent; D001323:Autoantibodies / Q000276:immunology*; D002446:Celiac Disease / Q000276:immunology; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005903:Gliadin / Q000097:blood / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood / Q000276:immunology*; D007223:Infant; D008297:Male; D018485:Muscle Fibers, Skeletal / Q000276:immunology*; D015995:Prevalence; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies; D013548:Sweden / Q000453:epidemiology
D001323:Autoantibodies; D007070:Immunoglobulin A; D005903:Gliadin