scholarly journals Type 1 Diabetes and Celiac Disease: Can (and Should) We Raise the Cut-off of Tissue Transglutaminase Immunoglobulin A to Decide Whether to Biopsy?

2020 ◽  
Vol 223 ◽  
pp. 8-10
Author(s):  
Stefano Guandalini
Keyword(s):  
Type 1 Diabetes ◽  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Immunoglobulin A

scholarly journals High Prevalence of Celiac Disease in Patients with Type 1 Diabetes Detected by Antibodies to Endomysium and Tissue Transglutaminase

2001 ◽  
Vol 15 (5) ◽  
pp. 297-301 ◽  
Author(s):  
PM Gillett ◽  
HR Gillett ◽  
DM Israel ◽  
DL Metzger ◽  
L Stewart ◽  
...  
Keyword(s):  
British Columbia ◽  
Type 1 Diabetes ◽  
Celiac Disease ◽  
Growth Parameters ◽  
Morphological Changes ◽  
Tissue Transglutaminase ◽  
Immunoglobulin A ◽  
Gluten Free Diet ◽  
Gluten Free

OBJECTIVE: To establish the prevalence of celiac disease (CD) in children with type 1 diabetes in British Columbia.PATIENTS AND METHODS: Two hundred thirty-three children with type 1 diabetes were prospectively screened for CD using blind testing with the current 'gold standard', immunoglobulin A endomysium antibody (EmA), and the novel immunoglobulin A tissue transglutaminase (tTG) antibody. Those children with positive results were offered small bowel biopsy; a gluten-free diet was recommended if CD was confirmed.RESULTS: Nineteen children were positive for EmA and had an elevated tTG level. One patient from this group was already known to have CD, and the other 18 patients consented to biopsy. One biopsy was normal, three biopsies demonstrated elevated intraepithelial lymphocyte counts with normal morphology and 14 biopsies had morphological changes consistent with CD. Growth parameters were normal in all patients, and nine of 19 children who were positive for EmA were asymptomatic. Seven patients had mild elevation of tTG levels alone. Two children from this latter group had normal biopsies, and five declined biopsy.CONCLUSIONS: At least 14 new cases of CD were detected in addition to four known cases, yielding an overall biopsy-confirmed prevalence of CD of 7.7% (18 of 233). The present study confirms that CD is as prevalent in the pediatric type 1 diabetic population in British Columbia as it is in Europe. Serological screening of these children is important because many children have no symptoms or signs suggestive of CD. This study suggests that tTG serology may also be useful in monitoring response and compliance with a gluten-free diet.

The Temporal Relationship Between the Onset of Type 1 Diabetes and Celiac Disease: A Study Based on Immunoglobulin A Antitransglutaminase Screening

PEDIATRICS ◽  
2004 ◽  
Vol 113 (5) ◽  
pp. e418-e422 ◽  
Author(s):  
N. Peretti ◽  
F. Bienvenu ◽  
C. Bouvet ◽  
N. Fabien ◽  
F. Tixier ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Celiac Disease ◽  
Temporal Relationship ◽  
Immunoglobulin A

Screening for autoimmune thyroiditis and celiac disease in minority children with type 1 diabetes

2018 ◽  
Vol 31 (8) ◽  
pp. 879-885 ◽  
Author(s):  
Elna Kochummen ◽  
Albara Marwa ◽  
Vatcharapan Umpaichitra ◽  
Sheila Perez-Colon ◽  
Vivian L. Chin
Keyword(s):  
Type 1 Diabetes ◽  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Retrospective Chart Review ◽  
Thyroid Antibodies ◽  
Minority Children ◽  
Institutional Review ◽  
Tissue Transglutaminase Antibodies ◽  
Optimal Screening

Abstract Background: Hashimoto’s thyroiditis (HT) and celiac disease (CD) are commonly associated with type 1 diabetes (T1DM). There is no consensus on screening, however, the American Diabetes Association (ADA) and the International Society for Pediatric and Adolescent Diabetes (ISPAD) recommend testing for thyroid function (TFT), thyroid antibodies and anti-tissue transglutaminase antibodies (TTG) IgA soon after diagnosis. TFT should be repeated every 1–2 years while TTG IgA should be tested for within 2 and 5 years. We hypothesize that the rate of HT and CD in our T1DM children is lower, so screening may need to be revised to reflect their underlying risk. Methods: An Institutional Review Board (IRB)-approved retrospective chart review was conducted on children with T1DM in the past 10 years. Age, sex, race, A1C, TFT, thyroid and celiac antibodies were obtained. t-Tests, the Wilcoxon-Mann-Whitney test and stepwise regression were performed. Results: Of 222 children with T1DM, with a mean age of 15.8±5.53 years, followed for 6.1±4.0 years, 53% female, mean A1C 11.1±1.9% and 87% African American (AA). Three had Graves’ disease (1.3%), three had HT (1.3%) and 97% were euthyroid. TFT were assessed on average every 1.3 years and thyroid antibodies every 2.5 years. Positive thyroid antibody was found in 11%, negative in 57% and unknown in 32%. The positive antibody group had higher mean A1C and TSH. No biopsy confirmed cases of CD (0%) were found when screened every 2.3 years. Conclusions: The number of individuals who screened positive for hypothyroid HT and CD was lower than expected in our population. Further studies are needed to assess the optimal screening frequency for HT and CD in minority children with T1DM.

scholarly journals Compliance to a Gluten-Free Diet in Swedish Children with Type 1 Diabetes and Celiac Disease

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4444
Author(s):  
Hanna Söderström ◽  
Julia Rehn ◽  
Matti Cervin ◽  
Cathrine Ahlstermark ◽  
Mara Cerqueiro Bybrant ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Older Children ◽  
Southern Sweden ◽  
Increased Risk ◽  
Iga Antibodies

Children with type 1 diabetes (T1D) are at increased risk of celiac disease (CD). The replacement of insulin in T1D, and the exclusion of gluten in CD, are lifelong, burdensome treatments. Compliance to a gluten-free diet (GFD) in children with CD is reported to be high, while compliance in children with both diseases has scarcely been studied. To examine compliance to a GFD in children with both T1D and CD, we analyzed tissue transglutaminase IgA-antibodies (tTGA). Moreover, associations between compliance and age, sex, glycemic control, ketoacidosis (DKA), body mass index (BMI), and time of CD diagnosis were investigated. Of the 743 children diagnosed with T1D in southern Sweden between 2005 and 2012, 9% were also diagnosed with CD. Of these, 68% showed good compliance to a GFD, 18% showed intermediate compliance, and 14% were classified as non-compliant. Higher age, poorer HbA1c, and more DKAs were significantly (p < 0.05) associated with poorer compliance. In conclusion, we found that compliance to a GFD in children with T1D and CD is likely be lower than in children with CD only. Our results indicate that children with both T1D and CD could need intensified dietary support and that older children and children with poor metabolic control are especially vulnerable subgroups.

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