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Horm Metab Res 2002; 34(4): 192-195
DOI: 10.1055/s-2002-26709
Original Clinical

© Georg Thieme Verlag Stuttgart · New York

General Screening for Celiac Disease is Advisable in Children with Type 1 Diabetes

U.  Spiekerkoetter 1 , J.  Seissler 2 , U.  Wendel 1
  • 1 Heinrich-Heine University Hospital, Department of Pediatrics, Düsseldorf, Germany
  • 2 German Diabetes Research Institute at the Heinrich-Heine University, Düsseldorf, Germany
Further Information

Publication History

29 October 2001

16 January 2002

Publication Date:
30 April 2002 (online)

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Abstract

The association between celiac disease (CD) and diabetes mellitus type 1 is well known. Only about one-third of all patients with CD are diagnosed in childhood as a result of typical gastrointestinal symptoms or growth retardation. To evaluate the feasibility of CD screening in diabetic children, we tested autoantibodies to tissue transglutaminase (tTGA) in all children with type 1 diabetes from our pediatric department during a 12-month period. In antibody-positive cases, we analyzed the clinical presentation and offered a duodenal biopsy to confirm the diagnosis and grade the severity of the inflammatory process. Of 205 children, 13 (6.3 %) were tTGA-positive. In seven of eight children who agreed to perform a biopsy, CD typical histological signs were detected (Marsh 1: n = 1, Marsh 3: n = 6). In three patients with confirmed disease, symptoms (iron deficiency, recurrent abdominal pain) remained undiscovered up to time of screening (latent form); in four, the disease was asymptomatic (silent form). Since clinical symptoms are mostly mild or absent in spite of severe signs of duodenal inflammation, we recommend tTGA screening in all diabetic children. This strategy may allow the identification of patients in an early stage in respect of prevention of long-term complications.

Key words

Tissue Transglutaminase Antibodies - Diabetes Mellitus - Gluten

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U. Spiekerkoetter

Vanderbilt University · D-2220 Medical Center North

1161 21st Ave. South · Nashville, 37232 Tennessee · USA

Email: ute.spiekerkoetter@mcmail.vanderbilt.edu ·

Fax: +1 (615) 322 22 10

Phone: +1 (615) 322 26 35

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