Prospective screening for biopsy proven coeliac disease, autoimmunity and malabsorption markers in Belgian subjects with Type 1 diabetes.
OBJECTIVE
To determine prospectively the prevalence of biopsy proven coeliac disease (CD) in an adult Type 1 diabetic population from Belgium with regards to associated auto-immunity and malabsorption.


RESULTS
Determination in 400 Type 1 diabetic patients of serum anti-endomysial and/or anti-transglutaminase auto-antibodies. All subjects with abnormal serology underwent an intestinal biopsy. Ten patients (2.5%) had positive antibodies. Diagnosis of CD was confirmed by an intestinal biopsy. Eight patients were symptom-free, although laboratory findings suggesting malabsorption were prominent in the presence of CD [microcytic anaemia, iron and folate deficiencies, low levels of 25(OH)vitamin D3, calcium and cholesterol]. Other auto-immune conditions, especially vitiligo, were found in patients with CD.


CONCLUSIONS
Asymptomatic coeliac disease occurs frequently in adult Type 1 diabetic patients, and is often associated with subclinical malabsorption. Screening should be part of routine evaluation, to implement life-long dietary gluten avoidance.
Department of Endocrinology and Nutrition, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium. buysschaert@diab.ucl.ac.be
M
M
Buysschaert
J P
JP
Tomasi
M P
MP
Hermans
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000032:analysis; D001327:Autoimmune Diseases / Q000150:complications / Q000453:epidemiology / Q000276:immunology; D015551:Autoimmunity / Q000276:immunology*; D001530:Belgium / Q000453:epidemiology; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D002446:Celiac Disease / Q000150:complications / Q000453:epidemiology / Q000276:immunology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D005260:Female; D006801:Humans; D008286:Malabsorption Syndromes / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies
D001323:Autoantibodies; D015415:Biomarkers