title: Coeliac screening in a Scottish cohort of children with type 1 diabetes mellitus: is DQ typing the way forward?
abstract: BACKGROUND
  Children with type 1 diabetes mellitus (T1DM) are at increased risk of coeliac disease (CD). Recent guidelines indicate coeliac screening should include HLA typing for CD predisposing (DQ2/DQ8) alleles and those negative for these alleles require no further coeliac screening.
  
  
  METHODS
  Children (n=176) with T1DM attending clinics across two Scottish regions were screened for HLA DQ2/DQ8 as part of routine screening. Data collected included the frequency of DQ2/DQ8 genotypes and the additional cost of HLA screening.
  
  
  RESULTS
  Overall, DQ2/DQ8 alleles were identified in 94% of patients. The additional cost of HLA typing was £3699.52 (£21.02 per patient). All patients with known CD (11/176) were positive for DQ2/DQ8 and all were diagnosed with CD within 5 years of T1DM diagnosis.
  
  
  CONCLUSIONS
  The vast majority of children with T1DM have CD-predisposing HLA genotypes limiting the number of patients that can be excluded from further screening. We conclude that HLA genotyping is not currently indicated for CD screening in this population.
authors.affiliation: MRC Centre for Reproductive Health, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK Departments of Paediatric Diabetes (RTM) and Paediatric Gastroenterology (PMG), Royal Hospital for Sick Children, Edinburgh, UK.
authors.forename: R T
authors.identifier: http://orcid.org/0000-0003-4650-3765
authors.initials: RT
authors.lastname: Mitchell
authors.affiliation: Departments of Paediatric Diabetes, Royal Aberdeen Children's Hospital, Aberdeen, UK.
authors.forename: A
authors.initials: A
authors.lastname: Sun
authors.affiliation: Departments of Paediatric Diabetes, Royal Aberdeen Children's Hospital, Aberdeen, UK.
authors.forename: A
authors.initials: A
authors.lastname: Mayo
authors.affiliation: BTS Tissue Typing, Ninewells Hospital, Dundee, UK.
authors.forename: M
authors.initials: M
authors.lastname: Forgan
authors.affiliation: BTS Tissue Typing, Ninewells Hospital, Dundee, UK.
authors.forename: A
authors.initials: A
authors.lastname: Comrie
authors.affiliation: Departments of Paediatric Diabetes (RTM) and Paediatric Gastroenterology (PMG), Royal Hospital for Sick Children, Edinburgh, UK.
authors.forename: P M
authors.initials: PM
authors.lastname: Gillett
mesh_terms: D000293:Adolescent; D002446:Celiac Disease / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D005260:Female; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006683:HLA-DQ Antigens / Q000235:genetics; D006650:Histocompatibility Testing / Q000191:economics / Q000379:methods*; D006801:Humans; D007223:Infant; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D011446:Prospective Studies; D012307:Risk Factors; D012606:Scotland
chemical_list: D006683:HLA-DQ Antigens
keywords: Coeliac Disease; Human Leucocyte Antigen; Screening; Type 1 Diabetes Mellitus