THE USE OF IGA-ANTIENDOMYSIAL ANTIBODY-TEST FOR SCREENING CELIAC-DISEASE IN INSULIN-DEPENDENT DIABETES-MELLITUS

The co-existence of coeliac disease (CD) and insulin-dependent diabete s mellitus (IDDM) was investigated using a specific recently described test: the IgA-antiendomysial antibody (EmA). All 138 ID diabetics liv ing in the province of Bergamo and ranging 0-20 yr (mean 13.1; 54 fema les, 84 males; mean duration of IDDM 5.7 yr, range 1-18), whose data h ad been carefully derived from multiple sources, were screened over a period of six months, IgA-EmA, antigliadin IgA and IgG (AGA) and HbA(1 C) were measured, Control serum samples for the same determinations we re obtained from 91 subjects without intestinal problems, Student's t test and Chi-square analysis were applied, Four diabetic patients had been previously diagnosed as having biopsy proven CD, They were IgG-AG A and EmA positive at the onset of CD, Two clinically silent diabetic patients were both AGA and EmA positive; they underwent intestinal bio psy and villous atrophy was found, Twenty-two CD symptom-free EmA nega tive diabetics (16.6%) were IgG-AGA positive vs 5 cases of control gro up (5.5%) (p<0.05). The prevalence of CD in our patients (4.35%) was s imilar to that found in IDDs of other countries and higher than in the general population; so we suggest that IDD patients be screened routi nely for CD, IgA-EmA was confirmed to be a reliable serological marker in assisting CD diagnosis and deciding which patients to biopsy. (C) 1996, Editrice Kurtis.