Use of HLA typing in diagnosing celiac disease in patients with type 1 diabetes.
OBJECTIVE
This study examines the use of HLA typing for the diagnosis of celiac disease in a group of Australians with type 1 diabetes.


METHODS
Subjects included 131 sequential patients with type 1 diabetes (mean age 17 years [range 10-37]), 77 patients with biopsy-proven celiac disease (mean age 52 years [range 12-84]), and 162 healthy control subjects (mean age 17 years [range 2 months to 56 years]). Subjects were prospectively screened for celiac disease using endomysial antibodies (EMAs), tissue transglutaminase antibodies (TTGAs), and celiac disease-specific HLA typing.


RESULTS
Celiac disease was diagnosed in 11 subjects after an intestinal biopsy (prevalence 8.4%). There was 95% agreement between TTGA and EMA for positive results and 100% for negative results. There was no significant difference for HLA DQ2 and DR4 among patients with type 1 diabetes with or without celiac disease.


CONCLUSIONS
The prevalence of celiac disease among patients with type 1 diabetes is higher than previously estimated in Australia. TTGA is a valuable diagnostic tool that can be used for screening celiac disease in patients with type 1 diabetes. HLA typing should not be used in the diagnosis of celiac disease in patients with type 1 diabetes because of the similarities of HLA types between patients with type 1 diabetes and those with celiac disease.
Doolan
Alessandra
A
Department of Clinical Immunology, Royal Prince Alfred Hospital, Camperdown, New South Wales 2050, Australia.
Donaghue
Kim
K
Fairchild
Jan
J
Wong
Melanie
M
Williams
Andrew J
AJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002446:Celiac Disease / Q000175:diagnosis / Q000276:immunology*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000276:immunology*; D005260:Female; D006681:HLA-D Antigens / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values
D006681:HLA-D Antigens