title: HLA-DQA1*05-DQB1*0201 positivity predisposes to coeliac disease in Czech diabetic children.
abstract: The aims of this study were to estimate the prevalence of coeliac disease (CD) in Czech children with insulin dependent diabetes mellitus (IDDM), and to determine the contribution of HLA-DQA1 and DQB1 to CD susceptibility among diabetic children. We screened 345 children with IDDM (186 boys and 159 girls, aged 0 to 18 y) for coeliac disease using the IgA endomysial antibodies (EMA) test. In all EMA-positive children, small bowel biopsy was performed to confirm CD. To determine the role of the HLA-DQA1*05-DQB1*0201 (DQ2) and the DQA1*03-DQB1*0302 (DQ8) molecules in CD susceptibility among diabetic children, the HLA-DQA1-DQB1 was genotyped in all EMA-positive, and in 186 of EMA-negative diabetic patients. EMA positivity was found in 15/345 (4.3%) diabetic children. The diagnosis of CD was established in 14/345 (4.1%) children based on a bioptic finding of villous atrophy, while the remaining EMA-positive patient had a normal bioptic finding, being diagnosed as a potential CD. The HLA DQA1*05-DQB1*0201 (DQ2) molecule conferred a significant risk of CD among diabetic children (odds ratio = 4.1, CI 95% 1.1-15), being found more frequently in diabetic children with CD (80%) than in diabetic children without CD (49%).
  
  
  CONCLUSIONS
  The high prevalence of CD (4.1%) found in Czech children with IDDM emphasizes the need for their regular screening. We suggest that this CD screening protocol may be individualized according to the DQA1*05-DQB1*0201 positivity.
authors.affiliation: 2nd Department of Paediatrics of the 2nd Medical School, Charles University, Prague, Czech Republic. Zdenek.Sumnik@Lfmotol.cuni.cz
authors.forename: Z
authors.initials: Z
authors.lastname: Sumník
authors.forename: S
authors.initials: S
authors.lastname: Kolousková
authors.forename: O
authors.initials: O
authors.lastname: Cinek
authors.forename: R
authors.initials: R
authors.lastname: Kotalová
authors.forename: J
authors.initials: J
authors.lastname: Vavrinec
authors.forename: M
authors.initials: M
authors.lastname: Snajderová
mesh_terms: D000293:Adolescent; D000328:Adult; D002446:Celiac Disease / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D018153:Czech Republic / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D005260:Female; D005838:Genotype; D006683:HLA-DQ Antigens / Q000235:genetics*; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence
chemical_list: D006683:HLA-DQ Antigens