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Elevated anti‐tissue transglutaminase antibodies in children newly diagnosed with type 1 diabetes do not always indicate coeliac disease
Author(s) -
Rinawi Firas,
Badarneh Basel,
Tanous Osama,
Bashir Husam,
TennenbaumRakover Yardena,
Peleg Sarit
Publication year - 2019
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.14398
Subject(s) - tissue transglutaminase , medicine , coeliac disease , serology , diabetes mellitus , antibody , type 1 diabetes , gastroenterology , type 2 diabetes , disease , immunology , endocrinology , biology , biochemistry , enzyme
Aim Elevated levels of anti‐tissue transglutaminase (anti‐ tTG ) antibody may spontaneously normalise in children with newly diagnosed type 1 diabetes, even if they eat gluten. The prevalence of this phenomenon and predictors of a subsequent coeliac disease ( CD ) diagnosis were determined. Methods The medical records of children diagnosed with type 1 diabetes at Ha'Emek Medical Centre, Israel, from 2007 to 2015, were retrospectively reviewed for elevated anti‐ tTG antibody levels. Demographic, clinical, laboratory and histological findings were compared between CD patients and those with transient coeliac serology. Results Of 425 patients with new onset type 1 diabetes, 34 (8%) had elevated anti‐ tTG antibodies: CD was diagnosed in 14, anti‐ tTG normalisation occurred in 13 and duodenal biopsies did not suggest CD in seven without anti‐ tTG antibody normalisation. Protective factors for a subsequent CD diagnosis were older age (p = 0.009) and mildly elevated anti‐ tTG antibody levels at the time of the type 1 diabetes diagnosis (p = 0.007), and decreased anti‐ tTG levels within six months of diagnosis (p = 0.03). Conclusion Serological follow‐up of a diet containing gluten is recommended for children who have newly diagnosed type 1 diabetes and slightly elevated anti‐ tTG antibodies with no symptoms that suggest CD .