Recommendations for Clinical Decision-making in Children with Type 1 Diabetes and Celiac Disease: Type 1 Diabetes and Celiac Disease Joint Working Group Report

It is well-known that in children with type 1 diabetes (T1D), the frequency of Celiac disease (CD) is increased due to mechanisms which are not fully elucidated but include autoimmune injury as well as shared genetic predisposition. Although histopathologic examination is the gold standard for diagn...

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Veröffentlicht in:Journal of clinical research in pediatric endocrinology Jg. 14; H. 1; S. 1 - 9
Hauptverfasser: Hatun, Şükrü, Dalgıç, Buket, Gökşen, Damla, Aydogdu, Sema, Savaş Erdeve, Şenay, Kuloğlu, Zarife, Doğan, Yaşar, Aycan, Zehra, Yeşiltepe Mutlu, Gül, Uslu Kızılkan, Nuray, Keser, Alev, Beşer, Ömer Faruk, Özbek, Mehmet Nuri, Bideci, Aysun, Ertem, Deniz, Evliyaoğlu, Olcay, Eliuz Tipici, Beyza, Gökçe, Tuğba, Muradoğlu, Serra, Taşkın, Orhun Çığ, Koca, Tuğba, Tütüncüler, Filiz, Baş, Firdevs, Darendeliler, Feyza, Selimoğlu, Mukadder Ayşe
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Turkey Galenos Yayinevi Tic. Ltd 01.03.2022
Galenos Publishing
Pediatric Endocrinology and Diabetes Society
Schlagworte:
anti-tissue transglutaminase-iga
Autoantibodies
Celiac disease
Celiac Disease - complications
Celiac Disease - diagnosis
Child
children
Clinical Decision-Making
Complications and side effects
Diabetes Mellitus, Type 1 - complications
Diabetes Mellitus, Type 1 - diagnosis
Diagnosis
Health aspects
Humans
Immunoglobulin A
Measurement
Pediatric research
Review
Risk factors
Transglutaminases
Type 1 diabetes
Turkey
Celiac disease
type 1 diabetes
Children
anti-tissue transglutaminase-IgA
ISSN:1308-5727, 1308-5735, 1308-5735
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Zusammenfassung:It is well-known that in children with type 1 diabetes (T1D), the frequency of Celiac disease (CD) is increased due to mechanisms which are not fully elucidated but include autoimmune injury as well as shared genetic predisposition. Although histopathologic examination is the gold standard for diagnosis, avoiding unnecessary endoscopy is crucial. Therefore, for both clinicians and patients’ families, the diagnosis of CD remains challenging. In light of this, a joint working group, the Type 1 Diabetes and Celiac Disease Joint Working Group, was convened, with the aim of reporting institutional data and reviewing current international guidelines, in order to provide a framework for clinicians. Several controversial issues were discussed: For CD screening in children with T1D, regardless of age, it is recommended to measure tissue transglutaminase-immunoglobulin A (tTG-IgA) and/or endomysial-IgA antibody due to their high sensitivity and specificity. However, the decision-making process based on tTG-IgA titer in children with T1D is still debated, since tTG-IgA titers may fluctuate in children with T1D. Moreover, seronegativity may occur spontaneously. The authors’ own data showed that most of the cases who have biopsy-proven CD had tTG-IgA levels 7-10 times above the upper limit. The decision for endoscopy based solely on tTG-IgA levels should be avoided, except in cases where tTG-IgA levels are seven times and above the upper limit. A closer collaboration should be built between divisions of pediatric endocrinology and gastroenterology in terms of screening, diagnosis and follow-up of children with T1D and suspicious CD.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1308-5727
1308-5735
1308-5735
DOI:10.4274/jcrpe.galenos.2021.2021.0139