期刊
ACTA PAEDIATRICA
卷 106, 期 4, 页码 639-646出版社
WILEY
DOI: 10.1111/apa.13695
关键词
Clinical diagnosis; Coeliac disease; Routine surveillance; Type 1 diabetes; Villous atrophy
类别
资金
- Academy of Finland Research Council for Health
- Competitive State Research Financing of the Expert Responsibility Areas of Tampere University Hospital
- Foundation for Pediatric Research
- Finnish Medical Foundation
- Sigrid Juselius Foundation
- Paivikki and Sakari Sohlberg Foundation
Aim: Screening children with type 1 diabetes for coeliac disease is controversial, because they often appear asymptomatic. Our aim was to establish whether active screening should be recommended. Methods: This study focused on 22 children whose coeliac disease was detected by serological screening during diabetes surveillance and 498 children diagnosed because of a clinical suspicion. We compared the clinical and histological data at diagnosis and the children's adherence and responses to a gluten-free diet. Results: The serological screening group suffered less from decreased growth (p = 0.016) and clinical symptoms (p < 0.001) at diagnosis than the clinical group. The groups did not differ in terms of age at diagnosis (p = 0.903), gender (p = 0.353), anaemia (p = 0.886), endomysial antibody titres (p = 0.789) and the severity of small-bowel mucosal atrophy (p = 0.104). They also showed equal adherence (p = 0.086) and clinical responses (p = 0.542) to a gluten-free diet after a median follow-up of 13 months. Conclusion: Coeliac patients detected during diabetes surveillance had signs of malabsorption and advanced mucosal damage that was similar to those diagnosed on a clinical basis. They often suffered from unrecognised gluten-dependent symptoms and showed excellent adherence and responses to a gluten-free diet. Our findings support active screening for coeliac disease in patients with type 1 diabetes.
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