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1型糖尿病患儿中乳糜泻的患病率及临床特征

Prevalence and clinical profile of celiac disease in children with type 1 diabetes mellitus.

作者信息

Joshi Rajesh, Madvariya Monica

机构信息

Department of Pediatrics, Bai Jerbai Wadia Hospital for children, Mumbai, Maharashtra, India.

出版信息

Indian J Endocrinol Metab. 2015 Nov-Dec;19(6):797-803. doi: 10.4103/2230-8210.167555.

Abstract

OBJECTIVE

To determine the prevalence of celiac disease (CD) in children with type 1 diabetes mellitus (TIDM) in follow-up in a Tertiary Care Referral Centre in Western India and to describe the clinical features indicative of CD in screened patients of TIDM.

STUDY DESIGN

In this single center observational cross-sectional study, 71 children who were diagnosed with TIDM were subjected to screening for CD with tissue transglutaminase antibody testing. Those who tested positive were offered intestinal biopsy for the confirmation of diagnosis. Clinical profiles of both groups of patients were compared and manifestations of CD were delineated.

RESULTS

The study revealed the prevalence of CD (based on serology) in children with Type 1 diabetes as 15.49%. The prevalence of biopsy-confirmed CD was 7.04%. Of the diagnosed CD patients, one-third were symptomatic at the time of screening while the majority was asymptomatic. The major clinical features indicative of CD were intestinal symptoms, anemia, rickets, and short stature. Autoimmune thyroid disease was prevalent in 29.6% of the patients with TIDM followed by CD.

CONCLUSIONS

The high prevalence of CD in children with Type 1 diabetes emphasizes the need for routine screening programs to be in place for these high-risk populations. The clinical profile of patients with CD further elaborates the indicators of CD and the need to screen for them.

摘要

目的

确定印度西部一家三级医疗转诊中心随访的1型糖尿病(TIDM)患儿中乳糜泻(CD)的患病率,并描述TIDM筛查患者中提示CD的临床特征。

研究设计

在这项单中心观察性横断面研究中,对71名被诊断为TIDM的儿童进行了组织转谷氨酰胺酶抗体检测以筛查CD。对检测呈阳性的患者进行肠道活检以确诊。比较两组患者的临床资料并描述CD的表现。

结果

研究显示1型糖尿病患儿中CD(基于血清学)的患病率为15.49%。经活检确诊的CD患病率为7.04%。在确诊的CD患者中,三分之一在筛查时出现症状,而大多数无症状。提示CD的主要临床特征为肠道症状、贫血、佝偻病和身材矮小。自身免疫性甲状腺疾病在29.6%的TIDM患者中普遍存在,其次是CD。

结论

1型糖尿病患儿中CD的高患病率强调了对这些高危人群实施常规筛查计划的必要性。CD患者的临床资料进一步阐述了CD的指标以及对其进行筛查的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d57/4673809/2e53fa4d57e1/IJEM-19-797-g001.jpg

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