To study, by sequential screening for gliadin antibodies (GA) and endomysial antibodies (EMA), the prevalence and clinical characteristics of coeliac disease (CD) in adult IDDM patients.
A series comprising 1664 diabetes patients [848 with IDDM, 745 with non-insulin-dependent diabetes (NIDDM) and 71 with secondary diabetes] were screened for GA.
IgA-or IgG-GA positive sera were analysed for EMA.
IgA-GA were more frequent in all the diabetes subgroups (13.7% in IDDM, 12.3% in NIDDM and 23.9% in secondary diabetes, P<0.001 in all three cases) than among healthy blood donors (4.7%). Two patients with NIDDM had CD.
Of the IDDM group (n=848), 8 had previously diagnosed CD and 14 more (of whom 7 could be biopsied) were EMA positive.
All had villous atrophy.
The minimum prevalence of CD (including probable cases) in IDDM was 2.6% (22/848).
Patients with previously known CD had more symptoms (P<0.001), more deficiency states (P<0.001) and more autoimmune diseases (P<0.04) than those identified by screening.
IDDM patients with a diabetes duration of 31-40 years were characterised by a higher prevalence of CD than patients with a duration of less than 30 years (6.7% vs. 1.7% ; P<0.02).
Serial analysis of GA and EMA confirmed a high prevalence of CD in adult IDDM (2.6%). False-positive IgA-GA test results are frequent in patients with diabetes, irrespective of type. (...)
Mots-clés Pascal : Diabète insulinodépendant, Coeliaque maladie, Association, Anticorps, Gliadine, Epidémiologie, Diagnostic, Sérologie, Prévalence, Adulte, Homme, Allemagne, Europe, Endocrinopathie, Immunopathologie, Maladie autoimmune, Appareil digestif pathologie, Intestin pathologie, Malabsorption intestinale
Mots-clés Pascal anglais : Insulin dependent diabetes, Coeliac disease, Association, Antibody, Gliadin, Epidemiology, Diagnosis, Serology, Prevalence, Adult, Human, Germany, Europe, Endocrinopathy, Immunopathology, Autoimmune disease, Digestive diseases, Intestinal disease, Intestinal malabsorption
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0202995
Code Inist : 002B21E01B. Création : 11/09/1998.