PREVALENCE OF CELIAC-DISEASE IN DIABETIC CHILDREN AND THEIR FIRST-DEGREE RELATIVES IN WEST ALGERIA - SCREENING WITH SEROLOGICAL MARKERS

Atypical and relatively silent forms of coeliac disease (CD) have been described in insulin-dependent diabetes mellitus (IDDM). Our aim was to evaluate the prevalence of CD-IDDM with serological markers and to investigate the presence of CD in the IDDM first-degree relatives. Dur ing 1993-94 we explored 116 IDDM patients reported as new cases and 38 1 first-degree relatives of IDDM patients. Determination of IgA and Ig G antigliadin antibodies (AGA) and IgA antiendomysium antibodies (AEA) was made. Jejunal biopsy was performed in symptomatic patients or in those with positive serological markers. (i) Nineteen IDDM-CD were ide ntified and 5 were suspected. Thus, the prevalence of CD in IDDM patie nts was between 16.4 and 20%. AGA and/or AEA were abnormal in 13 and n ormal in 5. Sensitivity was 80% for the three tests when used simultan eously and specificity was 100%. (ii) In the family study, 26 sera of asymptomatic first-degree relatives of IDDM patients were positive for at least one of the serological markers; 13 of them had villous atrop hy. Systematic serological screening in IDDM allowed us to detect CD a nd evaluate the true incidence.