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TITLE:

STUDY TO DETERMINE THE CELIAC DISEASE PREVALENCE IN ADOLESCENTS AND CHILDREN HAVING TYPE I DIABETES MELLITUS

AUTHORS:

Muhammad Junaid Aleem, Asma Mahmood, Parnia Ansari

ABSTRACT:

Introduction: While the relationship between celiac disease (CD) and type 1 diabetes mellitus (T1DM) is well known, there is a lack of published data on this association in our region. The purpose of this study was to establish the prevalence of CD in our hospital's Department of Pediatrics in a group of children with type 1 DM undergoing treatment. Methods: 87 patients (43 male and 44 female) with type 1 diabetes were selected. They ranged in age from 2-18. A group of eighty-seven healthy unrelated boys and girls matched for gender and age were taken as controls. All were screened for the celiac disease manifestations. Anti-tissue transglutaminase (anti-tTG) IgA was measured in blood collected from these patients. Patients with anti-tTG IgA positive underwent duodenal biopsy. Biopsy samples were obtained through an endoscopy procedure. Biopsy specimens were evaluated and CD was diagnosed when complete or partial atrophy of villi, lymphocytic infiltration, and crypt hypertrophy was observed as per the latest criteria of ESPGHAN Results: The celiac disease incidence in diabetic patients was found to be 3.4%, which was significantly higher than healthy controls. Females had a higher frequency of anti tTG IgA positivity than males. T1DM patients with CD were younger, had a shorter height, less weight and worsened glycemic control (p <0.05). We could not demonstrate a significant relationship between anti-TTG IgA positivity and the duration of diabetes. The results show that positive anti tTG IgA is a good immunity marker for use in celiac studies and that such tests are justified in type I diabetes patients irrespective of the duration of diabetes.

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