Beta-cell autoimmunity in pediatric celiac disease: the case for routine screening?
OBJECTIVE
To evaluate the prevalence of beta-cell autoimmunity and the usefulness of a type 1 diabetes screening in patients with celiac disease.


METHODS
We measured GAD antibodies (GADAs), insulinoma-associated protein 2 antigens (IA-2As), and insulin autoantibodies (IAAs) in 188 young Italian patients with celiac disease (66 male [35.1%]). Mean age at celiac disease diagnosis was 5.4 years (0.5-17.1), and mean celiac disease duration was 4.2 years (0-28.8). Celiac disease was diagnosed by jejunal biopsy after positivity for endomysial and tissue transglutaminase antibody was confirmed.


RESULTS
GADAs were positive in seven patients (3.7%), and IA-2As were positive in two patients. IAAs were negative in all cases. Metabolic evaluation was normal, and no patients developed diabetes during follow-up. There was no significant association among beta-cell autoimmunity and sex, age, pubertal stage, family history, or coexistence of other autoimmune disorders; compliance to a gluten-free diet was confirmed.


CONCLUSIONS
Our results showed a low prevalence of beta-cell autoimmunity and do not support a precocious screening for beta-cell autoimmunity in young celiac disease patients.
d'Annunzio
Giuseppe
G
Department of Pediatrics, University of Genoa, IRCCS G. Gaslini Institute, Genoa, Italy. giuseppedannunzio@ospedale-gaslini.ge.it
Giannattasio
Alessandro
A
Poggi
Elena
E
Castellano
Emanuela
E
Calvi
Angela
A
Pistorio
Angela
A
Barabino
Arrigo
A
Lorini
Renata
R
D000293:Adolescent; D017668:Age of Onset; D001323:Autoantibodies / Q000097:blood; D001327:Autoimmune Diseases / Q000453:epidemiology*; D015551:Autoimmunity; D002446:Celiac Disease / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007330:Insulin Antibodies / Q000097:blood; D050417:Insulin-Secreting Cells / Q000276:immunology*; D007558:Italy; D008297:Male
D001323:Autoantibodies; C096322:ICA512 autoantibody; D007330:Insulin Antibodies