Objective: To determine the accuracy of antigliadin and antiendomysium antibodies for the diagnosis of celiac disease in diabetic children and adolescents with and without digestive symptoms.
Study design: 177 children and adolescents with IDDM aged 15.4 +/- 5.4 years (mean +/- SD). Antigliadin (ELISA) and antiendomysium (IFI) antibodies were measured in 177 and 35 patients, respectively.
Results: Seven of 177 patients (3.9%; 95% confidence interval: 1.1-6.7) had celiac disease. The specificities of antiendomysium antibodies test (83%), IgA-antigliadin antibodies test (80%) and IgG-antigliadin antibodies test (90%) and the positive predictive values of these antibodies (55-75%) were lower than those obtained with the combined determination of these antibodies (100%). Negative antibodies and normal mucosa in one determination did not rule out the development of celiac disease later.
Conclusions: The combined determination of antigliadin and antiendomysium antibodies is the test of choice in screening for celiac disease in diabetic patients. The yearly investigation of these antibodies is a reliable method for detecting silent celiac disease in this population.