Prevalence of celiac disease in Brazilian children with type 1 diabetes mellitus.
OBJECTIVE
Although the relationship between celiac disease and diabetes mellitus type 1 is well recognized, there are no studies of this association in Brazil. This study aims to identify the prevalence of celiac disease in a group of children with diabetes mellitus type 1 undergoing treatment in the pediatric endocrinology division of a university hospital in Minas Gerais, Brazil.


METHODS
Immunoglobulin (Ig)A and IgG antigliadin antibodies (enzyme-linked immunoadsorbent assay) were measured in blood collected from 236 children and adolescents with diabetes mellitus type 1. Patients with antigliadin antibodies then had jejunal biopsy and determination of antiendomysial antibodies by indirect immunofluorescence.


RESULTS
Twenty-one patients had IgA or IgG antigliadin antibodies. Nineteen underwent jejunal biopsy. Six had mucosal alterations compatible with celiac disease; four had nonspecific histologic changes; nine had normal biopsies. Thirteen antigliadin antibody-positive patients were antiendomysial antibody-negative; one antiendomysial antibody-negative patient had celiac disease. The prevalence of celiac disease was 2.6% among 234 patients.


CONCLUSIONS
Measurement of antigliadin antibodies in patients with diabetes mellitus type 1 helped in the selection of patients to undergo jejunal biopsy. Antiendomysial antibodies were highly specific and moderately sensitive in predicting celiac disease. The prevalence of celiac disease was higher in diabetics than in the general population, suggesting the need for regular screening assessment of diabetic children.
Tanure
Mariella Guarino
MG
Division of Paediatric Endocrinology, University Hospital, Universidade Federal de Minas Gerais, Avenida Alfredo Balena 190, s/4061, 30130-100 Belo Horizonte, Brazil.
Silva
Ivani Novato
IN
Bahia
Magda
M
Penna
Francisco José
FJ
D000293:Adolescent; D000888:Antibodies, Anti-Idiotypic / Q000032:analysis; D001323:Autoantibodies / Q000032:analysis*; D015415:Biomarkers / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D002446:Celiac Disease / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis*; D007074:Immunoglobulin G / Q000032:analysis*; D007223:Infant; D007583:Jejunum / Q000473:pathology*; D008297:Male; D008403:Mass Screening; D011237:Predictive Value of Tests; D015995:Prevalence; D012680:Sensitivity and Specificity
D000888:Antibodies, Anti-Idiotypic; D001323:Autoantibodies; D015415:Biomarkers; D007070:Immunoglobulin A; D007074:Immunoglobulin G