Clinical and Laboratory ObservationsGluten-dependent diabetes-related and thyroid-related autoantibodies in patients with celiac disease☆
Section snippets
Patients and methods
Patients with biopsy-confirmed CD (n = 90, 61 female, mean age at diagnosis 10.1 years) diagnosed according to European Society for Paediatric Gastroenterology, Hepatology and Nutrition revised criteria5 were tested for serum levels of EMA, islet cell antibodies, glutamic acid decarboxylase antibodies, anti-insulin antibodies, and anti-thyreoperoxidase at diagnosis and after 6, 12, and 24 months of a gluten-free diet. Healthy university students (n = 90, 60 female, mean age 20.5 years) were
Results
All subjects tested positive for serum EMA at diagnosis, and by the end of the 2-year follow-up period on GFD, all tested negative. Six (6.6%) tested positive at diagnosis for serum ICA, 3 (3.3%) for GAD, and 2 (2.2%) for IAA, and therefore at least 1 IDDM-related autoantibody was present in 11 (11.1%) of 90 subjects at diagnosis. At the 6-month follow-up on GFD, GAD and IAA were negative in all 5 cases, but ICA persisted in 5 of 6 cases. At 12- and 24-month follow-up, all 11 patients tested
Discussion
In patients affected by CD or by dermatitis herpetiformis, several serum autoantibodies such as thyroid-related autoantibodies, diabetes-related autoantibodies, and rheumatoid immunoglobulin A factor may be present in addition to EMA.3, 8 The presence of serum organ-specific autoantibodies in patients with CD seems related to the presence of a second autoimmune disease and does not appear to be gluten-dependent.9 However, there is some evidence that a large series of gluten-dependent
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Reprint requests: Alessandro Ventura, MD, Istituto di Clinica Pediatrica, Università di Trieste, IRCCS “Burlo Garofolo”, Via dell'Istria 65/1, 34100 Trieste, Italy.