DIAGNOSTIC-VALUE OF SEROLOGICAL MARKERS FOR CELIAC-DISEASE IN DIABETIC CHILDREN AND ADOLESCENTS

Objective: To determine the accuracy of antigliadin and antiendomysium antibodies for the diagnosis of celiac disease in diabetic children a nd adolescents with and without digestive symptoms, Study design: 177 children and adolescents with IDDM aged 15.4+/-5.4 years (mean+/-SD). Antigliadin (ELISA) and antiendomysium (IFI) antibodies were measured in 177 and 35 patients, respectively. Results: Seven of 177 patients ( 3.9%; 95% confidence interval: 1.1-6.7) had celiac disease, The specif icities of antiendomysium antibodies test (83%), IgA-antigliadin antib odies test (80%) and IgG-antigliadin antibodies test (90%) and the pos itive predictive values of these antibodies (55-75%) were lower than t hose obtained with the combined determination of these antibodies (100 %). Negative antibodies and normal mucosa in one determination did not rule out the development of celiac disease later. Conclusions: The co mbined determination of antigliadin and antiendomysium antibodies is t he test of choice in screening for celiac disease in diabetic patients . The yearly investigation of these antibodies is a reliable method fo r detecting silent celiac disease in this population.