PREVALENCE OF CELIAC DISEASE IN CHILDREN AND ADOLESCENTS WITH TYPE I DIABETES MELLITUS

The association of celiac disease and type I diabetes mellitus has been known for some time. This study was undertaken to investigate the prevalence of celiac disease (CD) in diabetic children and adolescents. Eighty-seven patients (44 females, 43 males) aged 2- 18 years, with type I diabetes participated in this study. A group of 87 healthy unrelated girls and boys matched for age and gender served as controls. They were screened for the presence of celiac disease related marker [IgA - endomysial antibody (EMA)] and patients who were EMA positive further investigated with intestinal biopsy. Among diabetic patients a 3.4% prevalence of celiac disease was observed, a value significantly higher than that found among healthy controls. Girls were more frequently EMA positive than boys. Intestinal biopsies of all 3 patients with positive EMA showed a histologic picture confirming the diagnosis of CD. Diabetics with CD were significantly younger, had an earlier onset of diabetes, had a lower height and weight standard deviation score and poorer glycemic control compared with diabetics without CD (p<O.05). We failed to show any significant correlation between EMA- positivity and duration of diabetes. The results suggest EMA - positivity to be a good immunological marker for use in screening for celiac disease and such screening to be justified in our patients with type I diabetes mellitus, regardless of diabetes duration.