Screening for coeliac disease in adult insulin‐dependent diabetes mellitus
- 1 February 1998
- journal article
- Published by Wiley in Journal of Internal Medicine
- Vol. 243 (2), 133-140
- https://doi.org/10.1046/j.1365-2796.1998.00256.x
Abstract
To study, by sequential screening for gliadin antibodies (GA) and endomysial antibodies (EMA), the prevalence and clinical characteristics of coeliac disease (CD) in adult IDDM patients. A series comprising 1664 diabetes patients [848 with IDDM, 745 with non-insulin-dependent diabetes (NIDDM) and 71 with secondary diabetes] were screened for GA. IgA- or IgG-GA positive sera were analysed for EMA. IgA-GA were more frequent in all the diabetes subgroups (13.7% in IDDM,12.3% in NIDDM and 23.9% in secondary diabetes, P < 0.001 in all three cases) than among healthy blood donors (4.7%). Two patients with NIDDM had CD. Of the IDDM group (n = 848), 8 had previously diagnosed CD and 14 more (of whom 7 could be biopsied) were EMA positive. All had villous atrophy. The minimum prevalence of CD (including probable cases) in IDDM was 2.6% (22/848). Patients with previously known CD had more symptoms (P < 0.001), more deficiency states (P < 0.001) and more autoimmune diseases (P < 0.04) than those identified by screening. IDDM patients with a diabetes duration of 31-40 years were characterised by a higher prevalence of CD than patients with a duration of less than 30 years (6.7% vs. 1.7%; P < 0.02). Serial analysis of GA and EMA confirmed a high prevalence of CD in adult IDDM (2.6%). False-positive IgA-GA test results are frequent in patients with diabetes, irrespective of type. EMA analysis is the preferable screening tool for CD in diabetes.Keywords
This publication has 24 references indexed in Scilit:
- Symptoms and Haematologic Features in Consecutive Adult Coeliac PatientsScandinavian Journal of Gastroenterology, 1996
- Celiac disease and insulin-dependent diabetes mellitusDigestive Diseases and Sciences, 1994
- Coeliac disease in the year 2000: exploring the icebergThe Lancet, 1994
- Prevalence and Clinical Significance of Gliadin Antibodies in Healthy Children and AdultsScandinavian Journal of Gastroenterology, 1994
- Prevalence of coeliac disease in diabetic children and adolescents in SwedenActa Paediatrica, 1993
- The Controversy of the Use of Anti-gluten Antibody (AGA) as a Diagnostic Tool in Celiac DiseaseJournal of Pediatric Gastroenterology and Nutrition, 1991
- Screening of diabetic children for coeliac disease with antigliadin antibodies and HLA typing.Archives of Disease in Childhood, 1991
- Celiac disease in insulin-dependent diabetes mellitusThe Journal of Pediatrics, 1986
- IgA anti-endomysium antibody. A new immunological marker of dermatitis herpetiformis and coeliac diseaseBritish Journal of Dermatology, 1984
- ON ESTIMATING THE RELATION BETWEEN BLOOD GROUP AND DISEASEAnnals of Human Genetics, 1955