Prevalence of coeliac disease in diabetic children and adolescents in Sweden

Abstract

The aim of this study was to determine the minimum prevalence of coeliac disease in a group of 459 diabetic children and adolescents. Six patients were already known to have coeliac disease. A total of 436 patients with type 1 diabetes mellitus aged 2-21 years and with age at onset at 2 months to 17 years at three paediatric departments agreed to participate in the study. All patients were tested for gliadin IgA antibodies with a commercial kit (Pharmacia Gluten IgA EIA). Later, serum was tested for reticulin IgA/IgG antibodies. Nineteen patients had elevated gliadin IgA levels (> 25 AU). Eighteen underwent jejunal biopsy. Ten had total or subtotal villous atrophy. These 10 patients were reticulin IgA-positive. Of 417 gliadin IgA-negative patients, 408 were reticulin IgA/IgG-negative. Of 6 reticulin IgA-positive patients, 3 had total or subtotal villous atrophy. All 3 had become gliadin IgA-positive at the time of biopsy. Among 3 reticulin IgG-positive patients with IgA deficiency, 2 had total villous atrophy: 1 was not willing to be biopsied. Patients with total or subtotal villous atrophy were judged as having coeliac disease and were recommended a gluten-free diet. Within 2 months, gliadin IgA levels were normal in patients adhering to the diet. Five patients have gone through a second jejunal biopsy to date with normal histology in all 5. The 15 newly diagnosed patients with coeliac disease plus 6 already known patients with coeliac disease and type 1 diabetes mellitus gave a minimum prevalence of coeliac disease in diabetic children and adolescents of 21/459 = 4.6%.

Prevalence of celiac disease in patients with type 1 diabetes mellitus in the south of Iran

“…Despite many similarities between DM1 and CD, such as underlying genetic susceptibility associated with HLA class II and autoimmune phenomena, the prevalence rate of CD in DM1 appears to differ greatly in different geographical areas (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Both diseases were associated with a high frequency of HLA DQA1* 0501 and DQB1*0201 (DQ2) molecules worldwide (5).…”

Celiac Disease-Associated Autoimmune Endocrinopathies

“…CD shares many features with autoimmune disorders in general, such as a polygenic mode of inheritance, a strong association with HLA-DQ2 and HLA-DQ8 antigens, the production of a local inflammatory response (lymphocyte infiltration and cytokine production), the presence of autoantibodies in the circulation, female preponderance, and an association with other autoimmune diseases (1,2,11,14,19,30,33,88,91,92,97,104). There is a strong association of CD with HLA class II molecules with Ͼ90% of CD patients having the HLA-DQ ‫,1050ء1␣‬ ‫1020ء1␤‬ heterodimer (19,88,91,92,117).…”

Enteropathy precedes type 1 diabetes in the BB rat

“…Interestingly, there is a higher than normal incidence of overt coeliac disease in patients with T1D, with 2-10% (or more) of patients having histological evidence of gluten sensitive enteropathy. [12][13][14][15] In addition, approximately 10% of DQ2 homozygous T1D patients have circulatory IgA autoantibodies against tissue transglutaminase (tTG) 16 and a further 30% have circulating IgG anti-tTG autoantibodies. 17 Together with the fact that T1D and coeliac disease share overlapping susceptibility genes, 15 18 in particular the HLA DQB1*0201 allele, 19 these features are consistent with the idea that diet related immune responses in the gut could be important factors in the pathogenesis of diabetes.…”