Screening by anti-endomysium antibody for celiac disease in diabetic children and adolescents in Austria

J Pediatr Gastroenterol Nutr. 2000 Apr;30(4):391-6. doi: 10.1097/00005176-200004000-00008.

Abstract

Background: Unrecognized celiac disease (CD) may be found in a substantial proportion of patients with type I diabetes mellitus.

Methods: A cohort of 403 Austrian children and adolescents with type I diabetes mellitus (210 males and 193 females; age range, 1-22 years) was screened for celiac disease using the IgA anti-endomysium antibody test (EMA) and the immunoglobulin (Ig)G anti-gliadin (AGA-IgG) and IgA anti-gliadin (AGA-IgA) antibody test.

Results: Twelve patients' sera (2.98%) yielded positive EMA results and two patients' sera (0.49%) with IgA deficiency had high AGA-IgG values. All but one of these patients underwent intestinal biopsy. Six (1.49%) had clear histologic evidence of CD (flat mucosa), whereas three (0.74%) showed minor histologic changes (increase in intraepithelial lymphocytes) and four (0.99%), including the EMA-negative patients with IgA deficiency, had a normal mucosa. When the cases with silent and potential CD were combined, the overall prevalence in the current cohort was 2.98%. There was no difference in the hemoglobin (Hb)A1c level between antibody-positive and -negative patients, and subsequent gluten-free diet did not change this metabolic parameter.

Conclusion: The prevalence of clinically unrecognized CD, found by EMA screening, is much higher in Austrian children with diabetes than in a comparable population without diabetes. The prevalence of CD in diabetic children in Austria is distinctly lower, however, than in several other countries.

MeSH terms

  • Adolescent
  • Adult
  • Austria / epidemiology
  • Autoantibodies / blood*
  • Biomarkers / blood
  • Celiac Disease / complications
  • Celiac Disease / diagnosis*
  • Celiac Disease / epidemiology*
  • Celiac Disease / pathology
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / complications*
  • Female
  • Gliadin / immunology
  • Humans
  • Immunoglobulin G / immunology
  • Infant
  • Male
  • Mass Screening / methods
  • Muscle Fibers, Skeletal / immunology*
  • Prevalence

Substances

  • Autoantibodies
  • Biomarkers
  • Immunoglobulin G
  • Gliadin