| Title: |
Prospective antibody case finding of coeliac disease in type‐1 diabetes children: need of biopsy revisited |
| Authors: |
Popp, Alina; Mihu, Mihaela; Munteanu, Mihai; Ene, Adina; Dutescu, Monica; Colcer, Florin; Raducanu, Diana; Laurila, Kaija; Anca, Ioana; Mäki, Markku |
| Source: |
Acta Paediatrica ; volume 102, issue 3 ; ISSN 0803-5253 1651-2227 |
| Publisher Information: |
Wiley |
| Publication Year: |
2013 |
| Collection: |
Wiley Online Library (Open Access Articles via Crossref) |
| Description: |
Aim To evaluate whether coeliac disease ( CD ) can be diagnosed by measuring autoantibodies without small‐intestinal mucosal biopsies in children with type 1 diabetes. Methods Case finding of CD was undertaken in 181 consecutive I g A ‐competent children with type 1 diabetes using transglutaminase 2 ( TG 2) and endomysial I g A antibody ( EMA ) tests in serum and the rapid point of care test in fingertip whole‐blood sample. Endoscopy with intestinal biopsies was recommended for patients with high TG 2‐ I g A titres (>96 U) and in children with lower positive tests if either the EMA test or the rapid point of care test was additionally positive. The duodenal mucosal biopsies were graded according to the M arsh classification. Results The TG 2‐ I g A test had a 15.5% and the EMA test a 6.0% seropositivity. All seven biopsied high‐titre TG 2‐ I g A ‐positive children were symptom free and found to have CD ( M arsh 3 type lesion). These patients were also positive for EMA and in the rapid point of care test. Lower titre TG 2‐ I g A ‐positive children had histological M arsh 1 to 3a lesions. Conclusions None of the type 1 diabetes children with high TG 2‐ I g A titres would have needed endoscopy with duodenal biopsies to reach a CD diagnosis. Lower TG 2‐ I g A ‐positive patients need to be biopsied. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1111/apa.12117 |
| Availability: |
https://doi.org/10.1111/apa.12117; https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fapa.12117; https://onlinelibrary.wiley.com/doi/pdf/10.1111/apa.12117 |
| Rights: |
http://onlinelibrary.wiley.com/termsAndConditions#vor |
| Accession Number: |
edsbas.D693F508 |
| Database: |
BASE |