Diagnostic value of serological markers for celiac disease in diabetic children and adolescents

J Pediatr Endocrinol Metab. Nov-Dec 1998;11(6):751-6. doi: 10.1515/jpem.1998.11.6.751.

Abstract

Objective: To determine the accuracy of antigliadin and antiendomysium antibodies for the diagnosis of celiac disease in diabetic children and adolescents with and without digestive symptoms.

Study design: 177 children and adolescents with IDDM aged 15.4 +/- 5.4 years (mean +/- SD). Antigliadin (ELISA) and antiendomysium (IFI) antibodies were measured in 177 and 35 patients, respectively.

Results: Seven of 177 patients (3.9%; 95% confidence interval: 1.1-6.7) had celiac disease. The specificities of antiendomysium antibodies test (83%), IgA-antigliadin antibodies test (80%) and IgG-antigliadin antibodies test (90%) and the positive predictive values of these antibodies (55-75%) were lower than those obtained with the combined determination of these antibodies (100%). Negative antibodies and normal mucosa in one determination did not rule out the development of celiac disease later.

Conclusions: The combined determination of antigliadin and antiendomysium antibodies is the test of choice in screening for celiac disease in diabetic patients. The yearly investigation of these antibodies is a reliable method for detecting silent celiac disease in this population.

MeSH terms

  • Adolescent
  • Adult
  • Autoantibodies / blood
  • Biomarkers / blood
  • Celiac Disease / complications*
  • Celiac Disease / diagnosis*
  • Celiac Disease / epidemiology
  • Celiac Disease / immunology
  • Child
  • Diabetes Mellitus, Type 1 / complications*
  • Gliadin / immunology
  • Humans
  • Immunoglobulin A / blood
  • Immunoglobulin G / blood
  • Predictive Value of Tests
  • Prevalence
  • Spain

Substances

  • Autoantibodies
  • Biomarkers
  • Immunoglobulin A
  • Immunoglobulin G
  • Gliadin