Coeliac screening in a high-risk population: paediatric type 1 diabetes—a review of current guidelines and practice

Coeliac screening in a high-risk population: paediatric type 1 diabetes—a review of current... Background and aims Coeliac disease (CD) is more common in those with type 1 diabetes mellitus (T1DM) and may be asymptomatic despite the presence of intestinal histological changes. Optimal screening practice guidelines differ internationally. We undertook a retrospective audit to determine the efficacy of current screening practice for CD in T1DM in our centre. Methods All children and adolescents < 16 years, diagnosed with T1DM in our service and continuing to attend the service in January 2017 were included. Data on CD screening was collected and compared to current NICE, NASPGHAN and ESPGHAN guidelines. Results Of the 355 patients attending our service, 253 attended from T1DM diagnosis and all had CD screening performed in our centre. In 37 of 253 patients, IgA-TTG was positive, providing a cumulative prevalence of 14.6%. Of these, 31(83.78%) with an elevated TTG on screening had no recorded gastrointestinal symptoms or CD-related clinical signs. Of the 35 TTG plus EMA- positive patients, 22/35 (59.46%) had diagnostic endoscopic biopsy. Nineteen (83.4%) had CD confirmed, 1 (4.54%) had negative biopsy and 2 (9%) had equivocal, non-diagnostic changes. Conclusions Timely diagnosis of CD can prevent chronic ill health in affected individuals, and in patients with T1DM, CD is http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Irish Journal of Medical Science (1971 -) Springer Journals

Coeliac screening in a high-risk population: paediatric type 1 diabetes—a review of current guidelines and practice

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Publisher
Springer Journals
Copyright
Copyright © 2018 by Royal Academy of Medicine in Ireland
Subject
Medicine & Public Health; Internal Medicine; General Practice / Family Medicine
ISSN
0021-1265
eISSN
1863-4362
D.O.I.
10.1007/s11845-018-1831-0
Publisher site
See Article on Publisher Site

Abstract

Background and aims Coeliac disease (CD) is more common in those with type 1 diabetes mellitus (T1DM) and may be asymptomatic despite the presence of intestinal histological changes. Optimal screening practice guidelines differ internationally. We undertook a retrospective audit to determine the efficacy of current screening practice for CD in T1DM in our centre. Methods All children and adolescents < 16 years, diagnosed with T1DM in our service and continuing to attend the service in January 2017 were included. Data on CD screening was collected and compared to current NICE, NASPGHAN and ESPGHAN guidelines. Results Of the 355 patients attending our service, 253 attended from T1DM diagnosis and all had CD screening performed in our centre. In 37 of 253 patients, IgA-TTG was positive, providing a cumulative prevalence of 14.6%. Of these, 31(83.78%) with an elevated TTG on screening had no recorded gastrointestinal symptoms or CD-related clinical signs. Of the 35 TTG plus EMA- positive patients, 22/35 (59.46%) had diagnostic endoscopic biopsy. Nineteen (83.4%) had CD confirmed, 1 (4.54%) had negative biopsy and 2 (9%) had equivocal, non-diagnostic changes. Conclusions Timely diagnosis of CD can prevent chronic ill health in affected individuals, and in patients with T1DM, CD is

Journal

Irish Journal of Medical Science (1971 -)Springer Journals

Published: May 31, 2018

References

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