Insulin-dependent diabetes mellitus and coeliac disease

Abstract

The sensitive and specific tests now available to screen for coeliac disease have shown that the prevalence of this condition in the general population is higher than previously supposed. 1 Catassi C Ratsch IM Fabiani E et al. Coeliac disease in the year 2000: exploring the iceberg. Lancet. 1994; 343: 200-203 Summary PubMed Scopus (616) Google Scholar The prevalence of coeliac disease as determined by screening among patients with insulindependent diabetes mellitus (IDDM) is also higher than suspected–with rates of 1·0–7·8% (table). 2 Maki M Hallstrom O Huupponen T Vesikari T Visakorpi JK Increased prevalence of coeliac disease in diabetes. Arch Dis Child. 1984; 59: 739-742 Crossref PubMed Scopus (120) Google Scholar , 3 Savilahti E Simell O Koskimies S Rilva A Akerblom HK Celiac disease in insulin-dependent diabetes mellitus. J Pediatr. 1986; 108: 690-693 Summary Full Text PDF PubMed Scopus (117) Google Scholar , 4 Cacciari E Salardi S Volta U et al. 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QJM. 1982; 51: 329-335 PubMed Google Scholar Class-II HLA genes in the HLA-D region code for cell-surface molecules which bind and present antigenic peptides to T cells and have a major role in the pathogenesis of many autoimmune disorders. We propose that the clinical implication of this association is that IDDM patients should be screened and treated for coeliac disease. ARA=antireticulin antibody; AGA=antigliadin antibody; EmA=endomysial antibody.