title: [Study of celiac disease in adults with type 1 diabetes mellitus].
abstract: Celiac disease (CD) presents a wide clinical spectrum. There are asymptomatic or oligosymptomatic forms, which are difficult to diagnose. Since patients with untreated CD can develop severe complications, early diagnosis of these forms is important. Consequently, in groups at risk for CD, such as patients with type 1 diabetes (DM1), screening through determination of antigliadin (AGA), anti-tissue transglutaminase (ATG) and antiendomysial antibodies (EMA) is recommended. In the present study, 463 DM1 patients were screened for these antibodies. Patients who were positive for one or more were offered an upper endoscopy to obtain distal duodenum biopsies. Histological lesions, when present, were classified using Marsh's classification. Of the 463 patients, 62 (13.4%) were positive for at least one of the three antibodies, and 42 accepted to undergo an endoscopy. Fourteen patients (3% of the DM1 patients) were histologically diagnosed with CD. Most of these patients had no symptoms of CD, although some showed laboratory findings frequent in CD. The presence of clinical or analytical data compatible with CD was independent of the grade of histological lesions. Finally, we calculated the sensitivity and positive predictive value for each antibody. The most sensitive were ATG and EMA. Because of the technical simplicity of determining ATG with ELISA, in our opinion, this test should be the option of choice for screening.
authors.affiliation: Servicio de Aparato Digestivo, Hospital de Navarra, Pamplona, Navarra, España. mirva77@hotmail.com
authors.forename: Miren
authors.initials: M
authors.lastname: Vicuña Arregui
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Zozaya Urmeneta
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Martínez de Esteban
authors.forename: David
authors.initials: D
authors.lastname: Carral Martínez
authors.forename: Javier
authors.initials: J
authors.lastname: Pineda Arribas
authors.forename: Lluis
authors.initials: L
authors.lastname: Forga Llenas
authors.forename: José María
authors.initials: JM
authors.lastname: Martínez-Peñuela Virseda
authors.forename: Cristina
authors.initials: C
authors.lastname: Rodríguez Gutiérrez
authors.forename: Edelmiro
authors.initials: E
authors.lastname: Menéndez Torre
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Jiménez Pérez
authors.forename: Eduardo
authors.initials: E
authors.lastname: Layana Echezuri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D055815:Young Adult