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Åke Lernmark

Principal investigator

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Annual screening detects celiac disease in children with type 1 diabetes

Author

  • Karin Larsson
  • Annelie Carlsson
  • Elisabeth Cederwall
  • Bjorn Jonsson
  • Jan Neiderud
  • Bjorn Jonsson
  • Åke Lernmark
  • Sten Ivarsson

Summary, in English

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.

Department/s

  • Paediatrics (Lund)
  • Diabetes and Celiac Unit
  • Paediatric Endocrinology

Publishing year

2008

Language

English

Pages

354-359

Publication/Series

Pediatric Diabetes

Volume

9

Issue

4

Document type

Journal article

Publisher

Wiley-Blackwell

Topic

  • Pediatrics

Keywords

  • HLA-DQ
  • children
  • T1DM
  • annual screening
  • CD

Status

Published

Research group

  • Diabetes and Celiac Unit
  • Paediatric Endocrinology

ISBN/ISSN/Other

  • ISSN: 1399-543X