PREVALENCE OF COELIAC DISEASE IN TYPE 1 DIABETES MELLITUS: A STUDY PERFORMED VIA TESTS FOR ANTIGLIADIN ANTIBODIES

Abstract

The association between diabetes mellitus and coeliac disease has been described a number of times. By using tests for antireticulin antibodies, Maki et al. found a greater prevalence of the disease in diabetic subjects. In our opinion, this method is not wholly reliable, which led us to study the problem using the test for antigliadin antibodies (AGA) by immunofluorescence (IFL-AGA) or microenzyme-linked immunosorbent assay (ELISA-AGA). This technique appeared to be more specific and more sensitive (Cacciari et al.) in identifying children with coeliac disease. We examined 132 subjects with type I diabetes (66 m, 66 f) with age ranging from 2 3/12 to 22 7/12 years. Antigliadin antibodies were assayed from 0 to 17 2/12 years after diagnosis of diabetes. 8 subjects were seen to be positive with either one technique or the other: all subjects for IgG, 7 out of 8 for IgA. These subjects underwent duodenal biopsy (4th portion). In 1 case crypt hyperplasia with total villous atrophy was observed, while 3 patients had a crypt hyperplasia with severe partial villous atrophy. These 4 patients were diagnosed as probably suffering from coeliac disease since other causes of alteration to the mucosa similar to those observed are practically unknown in children. All subjects were positive for IFL-AGA belonging to class IgG. No positive patients had shown signs of malabsorption or diarrhoea. Prevalence was 1 : 33. It is probable that genetics might shed light on the relationship between these two diseases, both diseases being associated with HLA B8 and DR3 antigens.