High prevalence of celiac disease among Saudi children with type 1 diabetes: a prospective cross-sectional studyReportar como inadecuado

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BMC Gastroenterology

, 12:180

Intestinal disorders


BackgroundThere is lack of data on prevalence of celiac disease CD in children with type 1 diabetes T1D in Arabs in the Middle East. The present investigation aims to study the prevalence rate and clinical characteristics of CD among Saudi children with T1D using a combination of the most sensitive and specific screening serologic tests anti- tissue transglutaminase antibodies IgA anti-TTG and ednomyseal antibodies EMA and to determine the lower cut-off value of anti- anti-TTG level that best predicts CD in children with T1D.

MethodsChildren with T1D following in diabetic clinic have been prospectively screened for presence of CD, over a two-year period 2008–2010, by doing anti-TTG, EMA, and total IgA. Children with positive anti-TTG titres >50 U-ml and-or EMA and children with persistently low positive anti-TTG titres two readings 20–50 U-ml; within 6 months intervals had upper endoscopy and 6 duodenal biopsies.

ResultsOne hundred and six children with T1D have been screened for CD: age ranged between 8 months to 15.5 years 62 females. Nineteen children had positive anti-TTG and-or EMA, however only 12 children had biopsy proven CD 11.3%. Five of 12 had gastrointestinal symptoms 42%. Children with T1D and CD had significantly lower serum iron than children with T1D alone 8.5 μgm-L Vs 12.5 μgm-L; P = 0.014. The sensitivity and specificity of anti-TTG were 91.6% and 93.6%, with a positive and negative predictive value of 64.7% and 98.8%, respectively. Receiver operated characteristics analysis for the best cut-off value of anti-TTG level for diagnosis of CD was 63 units sensitivity 100% and specificity 98.8%.

ConclusionCD is highly prevalent among Saudi children with T1D. Anti-TTG titres more than 3 times the upper limit of normal has very high sensitivity and specificity for diagnosis of CD in T1D children.

KeywordsCeliac disease Type 1 diabetes Anti-tissue transglutaminase Ednomyseal antibody Saudi Arabia AbbreviationsAnti-TTGAnti- tissue transglutaminase antibodies IgA

CDCeliac disease

ELISAEnzyme linked immune-sorbent assay

EMAEdnomyseal antibodies

HbA1CGlycosylated hemoglobin

IgAImmunoglobulin subclass A

ROCReceiver operated characteristics

T1DType 1 diabetes.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-230X-12-180 contains supplementary material, which is available to authorized users.

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Autor: Abdulrahman Al-Hussaini - Nimer Sulaiman - Musa Al-Zahrani - Ahmed Alenizi - Imad El Haj

Fuente: https://link.springer.com/

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