The celiac iceberg: from the clinical spectrum to serology and histopathology in children and adolescents with type 1 diabetes mellitus and Down syndrome

Scandinavian Journal of Gastroenterology
Rosane Costa GomesHélcio De Sousa Maranhão

Abstract

The objective of this study is to investigate the occurrence of gastrointestinal (GI) and extraintestinal symptoms in children and adolescents with type 1 diabetes mellitus (DM1) and Down syndrome (DS) and their association with specific antibodies and histopathology of celiac disease (CelD), representing its clinical forms in the iceberg. Cross-sectional study (November 2009-December 2012) conducted at an outpatient care facility in Northeast Brazil including patients [DM1 (n = 111); DS (n = 77)] aged 10 months-18 years old. Measurement of anti-endomysial (EmA) and anti-tissue transglutaminase (anti-tTG) IgA antibodies was performed, as was that of anti-tTG-IgG in the cases with low serum IgA. The patients with antibody positivity were subjected to small intestine biopsy. GI symptoms occurred in 53.7% of the sample, extraintestinal symptoms in 4.3%, and antibody positivity in 28.2% (n = 53). Of those who underwent biopsy (n = 40), histopathological findings of CelD were found in 37.5% [DM1 = 5/111 (4.5%), DS = 10/77 (13.0%)]. GI symptoms were associated with antibody positivity, but not with the histopathology. The GI (32.5%), silent (5.0%), and potential (62.5%) forms of disease were detected. The prevalence of GI symptoms wa...Continue Reading

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Citations

Feb 10, 2019·Pediatric Diabetes·Marcia PuñalesBalduino Tschiedel
Jul 16, 2020·Clinical Pediatrics·Kathryn K OstermaierRobert G Voigt
Aug 18, 2017·The Medical Journal of Australia·Marjorie M WalkerDavid S Sanders
Apr 22, 2021·International Journal of Immunopathology and Pharmacology·Taoufik Ben Houmich, Brahim Admou
Jul 30, 2018·International Archives of Allergy and Immunology·Lyudmila V SavvateevaAndrey A Zamyatnin

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Methods Mentioned

BETA
biopsy
enzyme-linked immunoassay
biopsies

Software Mentioned

ANTHRO PLUS
ANTHRO

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