Use of HLA Typing in Diagnosing Celiac Disease in Patients With Type 1 Diabetes

• Published in: Diabetes care Vol. 28; no. 4; pp. 806 - 809
• Main Authors: Doolan, Alessandra, Donaghue, Kim, Fairchild, Jan, Wong, Melanie, Williams, Andrew J
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.04.2005
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; antibodies; Australia; Australians; Biological and medical sciences; biopsy; Celiac disease; Celiac Disease - diagnosis; Celiac Disease - immunology; Child; complications; Diabetes; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - immunology; Diabetes. Impaired glucose tolerance; Diagnosis; Digestive system; Disease; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Gastroenterology. Liver. Pancreas. Abdomen; Histocompatibility Testing; HLA-D Antigens; HLA-D Antigens - immunology; Humans; immunology; insulin-dependent diabetes mellitus; Male; Medical diagnosis; Medical sciences; Middle Aged; Other diseases. Semiology; patients; protein-glutamine gamma-glutamyltransferase; Reference Values; screening; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Type 1 diabetes; Australia; Oceania; Endocrinopathy; Human; Immunopathology; HLA-System; Typing; Major histocompatibility system; Autoimmune disease; Coeliac disease; Intestinal malabsorption; Type 1 diabetes; Digestive diseases; Intestinal disease; Diagnosis
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.28.4.806

OBJECTIVE:--This study examines the use of HLA typing for the diagnosis of celiac disease in a group of Australians with type 1 diabetes. RESEARCH DESIGN AND METHODS--Subjects included 131 sequential patients with type 1 diabetes (mean age 17 years [range 10-37]), 77 patients with biopsy-proven celiac disease (mean age 52 years [range 12-84]), and 162 healthy control subjects (mean age 17 years [range 2 months to 56 years]). Subjects were prospectively screened for celiac disease using endomysial antibodies (EMAs), tissue transglutaminase antibodies (TTGAs), and celiac disease-specific HLA typing. RESULTS:--Celiac disease was diagnosed in 11 subjects after an intestinal biopsy (prevalence 8.4%). There was 95% agreement between TTGA and EMA for positive results and 100% for negative results. There was no significant difference for HLA DQ2 and DR4 among patients with type 1 diabetes with or without celiac disease. CONCLUSIONS:--The prevalence of celiac disease among patients with type 1 diabetes is higher than previously estimated in Australia. TTGA is a valuable diagnostic tool that can be used for screening celiac disease in patients with type 1 diabetes. HLA typing should not be used in the diagnosis of celiac disease in patients with type 1 diabetes because of the similarities of HLA types between patients with type 1 diabetes and those with celiac disease.