SCREENING FOR CELIAC-DISEASE IN DUTCH CHILDREN WITH ASSOCIATED DISEASES

Our objective was to assess the frequency of coeliac disease in childr en with associated disorders in the province of ''Zuid-Holland'', The Netherlands. We therefore screened 115 children with Down's syndrome, 62 children with juvenile rheumatoid arthritis (JRA) and 46 children w ith diabetes mellitus for CD using the IgA- class of antigliadin, anti endomysium and antireticulin antibodies in serum, and a functional sug ar absorption test. The antiendomysium antibody test was the screening test that performed the best. Every patient who had at least one posi tive test underwent a jejunal biopsy for the diagnosis of CD. No assoc iation could be demonstrated between CD and diabetes mellitus. The fre quency of CD in Down's syndrome was 7.0%, which is much higher than th at found from screening the general population. CD was found in one ch ild with JRA (1.5%), who also had Down's syndrome. We recommend screen ing for CD in all persons with Down's syndrome using at least the anti endomysium antibody test.