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Celiac antibodies in children with type 1 diabetes - A diagnostic validation study.
Autoimmunity 2018; 51(2):81-88A

Abstract

INTRODUCTION

Autoimmune diseases, such as celiac disease (CD) and diabetes mellitus type 1, tend to co-occur within the same patient. The prevalence of CD in diabetic children is higher than in the general population, and is estimated to be 0.6-16.4%. The diagnosis of CD is based on histopathological examination and serological testing, however, these methods are still imperfect and new diagnostic algorithms should be considered.

AIM

The aim of the study was to assess the diagnostic value of serological tests detecting antibodies against deamidated gliadin peptide, endomysium, tissue transglutaminase, neo-epitope tissue transglutaminase and to identify HLA-related genetic predisposition to CD in patients with type 1 diabetes mellitus (DM1).

METHODS

Autoantibodies were measured in the sera of 392 children suffering from DM1 aged 1-19 years old (mean 11.76 ± 4.14 years old). Additionally, PCR-based assessment of HLA DQ2/DQ8 genotyping was performed.

RESULTS

A positive result of at least one serological test was obtained from 81 children (20.66%). The sensitivity and specificity were 76.47% and 91.67% for anti-DGP IgA, 70.59% and 58.33% for IgG anti-DGP, respectively. A positive predictive value was 100% for the anti-TG IgA at cutoff levels of 5 and 10 times higher than upper limit of reference values. HLA DQ2 and/or DQ8 were found in 97.6% of examined children.

CONCLUSIONS

Tests based on anti-TG IgA are more accurate for detecting CD in children with type 1 diabetes than anti-DGP IgA. A high percentage of diabetic children carry HLA alleles predisposing to CD, which indicates that genetic screening in this group of patients is not obligated.

Authors+Show Affiliations

a Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age , Medical University of Warsaw , Warsaw , Poland.a Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age , Medical University of Warsaw , Warsaw , Poland.b Department of Pediatrics , Medical University of Warsaw , Warsaw , Poland.c Department of Pathomorphology , Pediatric Hospital of Warsaw Medical University , Warsaw , Poland.a Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age , Medical University of Warsaw , Warsaw , Poland.a Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age , Medical University of Warsaw , Warsaw , Poland.a Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age , Medical University of Warsaw , Warsaw , Poland.d Department of Pediatric Endocrinology , Medical University of Warsaw , Warsaw , Poland.a Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age , Medical University of Warsaw , Warsaw , Poland.

Pub Type(s)

Journal Article
Validation Study

Language

eng

PubMed ID

29350070

Citation

Lewandowska, Katarzyna, et al. "Celiac Antibodies in Children With Type 1 Diabetes - a Diagnostic Validation Study." Autoimmunity, vol. 51, no. 2, 2018, pp. 81-88.
Lewandowska K, Ciepiela O, Szypowska A, et al. Celiac antibodies in children with type 1 diabetes - A diagnostic validation study. Autoimmunity. 2018;51(2):81-88.
Lewandowska, K., Ciepiela, O., Szypowska, A., Wyhowski, J., Głodkowska-Mrówka, E., Popko, K., ... Demkow, U. (2018). Celiac antibodies in children with type 1 diabetes - A diagnostic validation study. Autoimmunity, 51(2), pp. 81-88. doi:10.1080/08916934.2018.1427226.
Lewandowska K, et al. Celiac Antibodies in Children With Type 1 Diabetes - a Diagnostic Validation Study. Autoimmunity. 2018;51(2):81-88. PubMed PMID: 29350070.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Celiac antibodies in children with type 1 diabetes - A diagnostic validation study. AU - Lewandowska,Katarzyna, AU - Ciepiela,Olga, AU - Szypowska,Agnieszka, AU - Wyhowski,Jan, AU - Głodkowska-Mrówka,Eliza, AU - Popko,Katarzyna, AU - Ostafin,Magdalena, AU - Pyrżak,Beata, AU - Demkow,Urszula, Y1 - 2018/01/19/ PY - 2018/1/20/pubmed PY - 2019/10/8/medline PY - 2018/1/20/entrez KW - Celiac disease KW - HLA DQ2/DQ8 KW - deamidated gliadin antibodies KW - endomysial antibodies KW - transglutaminase antibodies SP - 81 EP - 88 JF - Autoimmunity JO - Autoimmunity VL - 51 IS - 2 N2 - INTRODUCTION: Autoimmune diseases, such as celiac disease (CD) and diabetes mellitus type 1, tend to co-occur within the same patient. The prevalence of CD in diabetic children is higher than in the general population, and is estimated to be 0.6-16.4%. The diagnosis of CD is based on histopathological examination and serological testing, however, these methods are still imperfect and new diagnostic algorithms should be considered. AIM: The aim of the study was to assess the diagnostic value of serological tests detecting antibodies against deamidated gliadin peptide, endomysium, tissue transglutaminase, neo-epitope tissue transglutaminase and to identify HLA-related genetic predisposition to CD in patients with type 1 diabetes mellitus (DM1). METHODS: Autoantibodies were measured in the sera of 392 children suffering from DM1 aged 1-19 years old (mean 11.76 ± 4.14 years old). Additionally, PCR-based assessment of HLA DQ2/DQ8 genotyping was performed. RESULTS: A positive result of at least one serological test was obtained from 81 children (20.66%). The sensitivity and specificity were 76.47% and 91.67% for anti-DGP IgA, 70.59% and 58.33% for IgG anti-DGP, respectively. A positive predictive value was 100% for the anti-TG IgA at cutoff levels of 5 and 10 times higher than upper limit of reference values. HLA DQ2 and/or DQ8 were found in 97.6% of examined children. CONCLUSIONS: Tests based on anti-TG IgA are more accurate for detecting CD in children with type 1 diabetes than anti-DGP IgA. A high percentage of diabetic children carry HLA alleles predisposing to CD, which indicates that genetic screening in this group of patients is not obligated. SN - 1607-842X UR - https://www.unboundmedicine.com/medline/citation/29350070/Celiac_antibodies_in_children_with_type_1_diabetes___A_diagnostic_validation_study_ L2 - http://www.tandfonline.com/doi/full/10.1080/08916934.2018.1427226 DB - PRIME DP - Unbound Medicine ER -