Department of Pediatric Gastroenterology, Adana City Training and Research Hospital, Adana, Turkey.
Department of Pediatric Endocrinology, Adana City Training and Research Hospital, Adana, Turkey.
Turk J Gastroenterol. 2023 Mar;34(3):293-297. doi: 10.5152/tjg.2023.22775.
This study aims to detect the rate of celiac antibody test positivity in pediatric patients diagnosed with type 1 diabetes mellitus (T1DM) and determine the characteristics of the patient groups diagnosed with and without celiac disease (CD).
This study was conducted retrospectively in Adana City Training and Research Hospital, Pediatric Endocrinology Outpatient Clinic with the patients diagnosed with T1DM between September 17, 2017, and January 1, 2022. The patients were examined by 3 different groups. Group 1: celiac patient group, group 2: serology false positive group, and group 3: serology negative group.
The study included 418 patients, 228 (54.5%) males and 190 (45.5%) females. About 6% of the patients (25 patients) were in the celiac patient group, 12.6% (53 patients) in the serology false positive group, and 81.3% (340 patients) in the serology negative group. The age at diagnosis was 10 (7.2-12.9) years in the celiac patient group and 8.8 (6.2-12.00) years in the serology false positive group (P = .559). Among 53 patients in the serology false positive group, spontaneous normalization was observed in 66% (35 patients), and positivity was continued during the test follow-up period in 34% (18 patients). There was no significant difference in terms of sex (P = .101), and HbA1c values at diagnosis (P = .557). Tissue transglutaminase IgA titer was 20× Upper limit of normal (ULN) in the celiac patient group and 2.52× ULN in the serology false positive group.
T1DM and CD are both autoimmune diseases concurrently seen together. CD antibody positivity may be observed at the first presentation of T1DM. While the majority of these antibodies become negative during the follow-up, we wanted to highlight the false positive antibody titers and emphasize that these patients should be followed by endocrinologists and gastroenterologists together.
本研究旨在检测诊断为 1 型糖尿病（T1DM）的儿科患者中抗麸质抗体检测阳性率，并确定诊断为和未诊断为乳糜泻（CD）的患者群体的特征。
本研究在阿德亚曼城市培训和研究医院儿科内分泌门诊进行，纳入 2017 年 9 月 17 日至 2022 年 1 月 1 日期间诊断为 T1DM 的患者。患者由 3 个不同的小组进行检查。第 1 组：乳糜泻患者组，第 2 组：血清学假阳性组，第 3 组：血清学阴性组。
研究纳入 418 例患者，男 228 例（54.5%），女 190 例（45.5%）。约 6%的患者（25 例）为乳糜泻患者组，12.6%（53 例）为血清学假阳性组，81.3%（340 例）为血清学阴性组。乳糜泻患者组的诊断年龄为 10 岁（7.2-12.9），血清学假阳性组为 8.8 岁（6.2-12.00）（P=.559）。在血清学假阳性组的 53 例患者中，66%（35 例）自发恢复正常，在随访期间继续阳性的占 34%（18 例）。两组间的性别（P=.101）和诊断时的糖化血红蛋白值（P=.557）无显著差异。乳糜泻患者组组织转谷氨酰胺酶 IgA 滴度为 20×正常值上限（ULN），血清学假阳性组为 2.52×ULN。
T1DM 和 CD 都是自身免疫性疾病，同时存在。在 T1DM 的首次发作时可能会观察到 CD 抗体阳性。虽然这些抗体在随访期间大多数会转为阴性，但我们想强调假阳性抗体滴度，并强调这些患者应同时由内分泌学家和胃肠病学家进行随访。
