Prevalence of IgA-antiendomysium and IgA-antigliadin autoantibodies at diagnosis of insulin-dependent diabetes mellitus in Swedish children and adolescents
Ak. Carlsson et al., Prevalence of IgA-antiendomysium and IgA-antigliadin autoantibodies at diagnosis of insulin-dependent diabetes mellitus in Swedish children and adolescents, PEDIATRICS, 103(6), 1999, pp. 1248-1252
Objective. This study was conducted to investigate the prevalence of celiac
disease (CD) in children and adolescents at diagnosis of insulin-dependent
diabetes mellitus (IDDM) before insulin treatment was started.
Material and Methods. At diagnosis of IDDM, and before treatment was starte
d, 115 children and adolescents were screened for IgA- antiendomysium (EMA)
and IgA-antigliadin antibodies (AGA). Those found to be EMA-positive and/o
r AGA-positive were investigated further with intestinal biopsy.
Results. Of the 115 patients, 2 had known CD at diagnosis of IDDM; of the r
emainder of patients, 6% (7/113) were found to be EMA-positive and 9% (10/1
13) were found to have AGA levels above normal. Of the 6 patients who under
went biopsy, 5 manifested villous atrophy. In addition, 2 patients with hig
h EMA and AGA antibody titers refused biopsy, and 4 patients with low EMA a
nd/or AGA titers were found to have normal titers at control before biopsy
decision.
Conclusion. Because the prevalence of CD at diagnosis of IDDM would seem to
be 6% to 8%, screening for CD seems to be justified among patients with ne
wly diagnosed IDDM.