INCIDENCE OF CELIAC DISEASE AMONG CHILDREN DIAGNOSED WITH TYPE I DIABETES
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Keywords
Celiac Disease, Type 1 Diabetes Mellitus, Pediatric Autoimmune Disorders, Gluten-Free Diet, Serological Screening, Histological Analysis
Abstract
Background: Celiac disease (CD) is an autoimmune disorder triggered by gluten ingestion in genetically predisposed individuals, and it frequently coexists with Type 1 Diabetes Mellitus (T1DM), another autoimmune condition.
Objectives: This study aimed to determine the prevalence of celiac disease (CD) among children with Type 1 Diabetes Mellitus (T1DM) and to evaluate the clinical and histological characteristics of CD in this population
Study design: Cross sectional study
Settings: This study was conducted at Akhtar Saeed Trust Hospital Lahore from November 2023 to May 2024.
Study duration: 6th October 2020 to 5th April 2021
Methods: We conducted a cross-sectional study involving 125 pediatric patients with T1DM, aged 5 to 18 years, at a tertiary care hospital. We screened participants for CD using serological tests for tissue transglutaminase IgA (tTG-IgA), deamidated gliadin peptide IgG (DGP-IgG) in case of selective IgA deficiency, and confirmed positive cases with upper gastrointestinal endoscopy and small bowel biopsy. We recorded demographic data and clinical symptoms..
Results: Out of 125 patients, 18 (14.4%) tested positive for CD-specific antibodies. Among these, 12% were positive for tTG-IgA, and 2.4% with IgA deficiency were positive for DGP-IgG. Histological examination revealed that 50% of seropositive patients had Marsh III (villous atrophy), 22.2% had Marsh II (hyperplastic lesions), and 16.7% had Marsh I (infiltrative lesions). Notably, 38.9% of patients with CD were asymptomatic, with abdominal pain (27.8%) and diarrhea (22.2%) being the most common symptoms
Conclusion: Prevalence of CD among children with T1DM in our study (14.4%) supports the higher risk of CD in this population. The significant proportion of asymptomatic cases highlights the importance of routine CD screening in T1DM patients to prevent potential complications and ensure optimal management. Early diagnosis and multidisciplinary care are essential to address both conditions effectively.
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Muhammad Burhan Anjum
Ex house officer at Akhtar Saeed Trust Hospital Lahore
Basil Siddique
Senior Medical Officer at Ghurki Trust Teaching Hospital, Lahore
Tayiba Ilyas
Ex House Officer at Civil Hospital Sialkot
Faheem Ashraf
Doctor of Medicine Tentishev Satkynbai Memorial Asian Medical Institute
Qanita Shahzad
Medical Officer, Pvt Clinic (Saima Medical Centre)
Muhammad Faizan Ul Haq
Ex House Officer at Arif Memorial Teaching Hospital, Lahore