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Annual screening detects celiac disease in children with type 1 diabetes

Larsson, Karin; Carlsson, Annelie LU ; Cederwall, Elisabeth; Jonsson, Bjorn; Neiderud, Jan; Jonsson, Bjorn; Lernmark, Åke LU and Ivarsson, Sten LU (2008) In Pediatric Diabetes 9(4). p.354-359
Abstract
Objective: To investigate the prevalence of celiac disease (CD) in a cohort of type 1 diabetes mellitus (T1DM) children and adolescents at the time of clinical diagnosis and to evaluate the screening procedure and possible role of human leukocyte antigen (HLA)-DQ during a 5-yr follow-up. Research design and methods: The study group was a cohort of 300 newly diagnosed T1DM children and youths younger than 20 yr followed for 5 yr at six clinical centers for pediatric diabetes in the region Skane in Sweden. Immunoglobulin A endomysium antibodies were used to screen the patients annually to be considered for an intestinal biopsy. All patients were analyzed for HLA-DQA1-B1 genotypes. Results: While 0.7% (2/300) already had a diagnosed... (More)
Objective: To investigate the prevalence of celiac disease (CD) in a cohort of type 1 diabetes mellitus (T1DM) children and adolescents at the time of clinical diagnosis and to evaluate the screening procedure and possible role of human leukocyte antigen (HLA)-DQ during a 5-yr follow-up. Research design and methods: The study group was a cohort of 300 newly diagnosed T1DM children and youths younger than 20 yr followed for 5 yr at six clinical centers for pediatric diabetes in the region Skane in Sweden. Immunoglobulin A endomysium antibodies were used to screen the patients annually to be considered for an intestinal biopsy. All patients were analyzed for HLA-DQA1-B1 genotypes. Results: While 0.7% (2/300) already had a diagnosed symptomatic CD, an additional 3% (10/300) had silent CD at the diagnosis of T1DM. During follow-up, another 6% (17/300) developed CD as follows: 10 after 1 yr, 5 after 2 yr, 1 after 3 yr, and 1 after 5 yr. Therefore, the cumulative frequency of CD confirmed by intestinal biopsies was 10% (29/300). HLA genotypes among T1DM patients developing CD were not different from those among patients with T1DM alone. Conclusions: Our study confirmed the low prevalence (0.7%) of diagnosed symptomatic CD at the time of clinical diagnosis but document by screening an increasing prevalence of silent CD during a 5-yr follow-up to reach an overall prevalence of 10%. We suggest that children with T1DM should be screened for CD at the onset of T1DM and annually for a minimum of at least 2 yr. HLA genotypes among T1DM patients developing CD were not different from those among patients with T1DM alone. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
HLA-DQ, children, T1DM, annual screening, CD
in
Pediatric Diabetes
volume
9
issue
4
pages
354 - 359
publisher
Wiley-Blackwell
external identifiers
  • wos:000258078500003
  • scopus:48649090823
ISSN
1399-543X
DOI
10.1111/j.1399-5448.2008.00367.x
language
English
LU publication?
yes
id
5d81077a-5e36-48a0-8f1e-226ed4fc0cfb (old id 1253614)
date added to LUP
2008-10-28 15:57:42
date last changed
2017-08-13 03:41:24
@article{5d81077a-5e36-48a0-8f1e-226ed4fc0cfb,
  abstract     = {Objective: To investigate the prevalence of celiac disease (CD) in a cohort of type 1 diabetes mellitus (T1DM) children and adolescents at the time of clinical diagnosis and to evaluate the screening procedure and possible role of human leukocyte antigen (HLA)-DQ during a 5-yr follow-up. Research design and methods: The study group was a cohort of 300 newly diagnosed T1DM children and youths younger than 20 yr followed for 5 yr at six clinical centers for pediatric diabetes in the region Skane in Sweden. Immunoglobulin A endomysium antibodies were used to screen the patients annually to be considered for an intestinal biopsy. All patients were analyzed for HLA-DQA1-B1 genotypes. Results: While 0.7% (2/300) already had a diagnosed symptomatic CD, an additional 3% (10/300) had silent CD at the diagnosis of T1DM. During follow-up, another 6% (17/300) developed CD as follows: 10 after 1 yr, 5 after 2 yr, 1 after 3 yr, and 1 after 5 yr. Therefore, the cumulative frequency of CD confirmed by intestinal biopsies was 10% (29/300). HLA genotypes among T1DM patients developing CD were not different from those among patients with T1DM alone. Conclusions: Our study confirmed the low prevalence (0.7%) of diagnosed symptomatic CD at the time of clinical diagnosis but document by screening an increasing prevalence of silent CD during a 5-yr follow-up to reach an overall prevalence of 10%. We suggest that children with T1DM should be screened for CD at the onset of T1DM and annually for a minimum of at least 2 yr. HLA genotypes among T1DM patients developing CD were not different from those among patients with T1DM alone.},
  author       = {Larsson, Karin and Carlsson, Annelie and Cederwall, Elisabeth and Jonsson, Bjorn and Neiderud, Jan and Jonsson, Bjorn and Lernmark, Åke and Ivarsson, Sten},
  issn         = {1399-543X},
  keyword      = {HLA-DQ,children,T1DM,annual screening,CD},
  language     = {eng},
  number       = {4},
  pages        = {354--359},
  publisher    = {Wiley-Blackwell},
  series       = {Pediatric Diabetes},
  title        = {Annual screening detects celiac disease in children with type 1 diabetes},
  url          = {http://dx.doi.org/10.1111/j.1399-5448.2008.00367.x},
  volume       = {9},
  year         = {2008},
}