A new study from researchers at Cincinnati Children’s Hospital may have found a method to more easily identify celiac disease in patients with type 1 diabetes (T1DM).
Celiac disease prevalence in children with T1DM is approximately 5-8%, which is significantly higher than the general population. Because these conditions frequently co-occur, screening for celiac disease is recommended in children with T1DM, even if in the absence of symptoms. Current celiac disease screening methods include blood tests like TTG IgA. However, TTG IgA levels can sometimes be falsely elevated in children with T1DM, leading to unnecessary endoscopy procedures.
Celiac disease and type 1 diabetes are both autoimmune disorders, and they share a genetic predisposition. In individuals with type 1 diabetes, the immune system attacks insulin-producing cells in the pancreas, while in celiac disease, the immune system targets the small intestine in response to gluten. Both conditions are linked to specific genes, particularly HLA-DQ2 and HLA-DQ8, which increase susceptibility to these autoimmune diseases. This genetic overlap explains why children with type 1 diabetes are at higher risk for developing celiac disease. Managing both conditions requires careful attention to diet and regular screening to prevent complications, making early detection essential for optimal care.
In the new study, led by Dr. Danny Mallon, researchers aimed to identify laboratory markers to more accurately predict celiac disease in pediatric T1DM patients. They found that elevated TTG IgA levels (>10x the upper limit of normal) and positive endomysial antibody (EMA) tests were strong predictors of celiac disease in this pediatric cohort. They concluded that while symptoms and other factors are inconsistent predictors of celiac disease in children with T1DM, elevated TTG IgA and positive EMA results may be more reliable markers. Additional research in this area is needed to establish serological thresholds for celiac disease diagnosis in T1DM patients.
The findings highlight the importance of proactive celiac disease screening in children with T1DM. Elevated TTG IgA levels should prompt further testing for celiac disease to ensure early diagnosis and better management of both conditions.
Study Authors: Jessica Rutsky, Andrew Krueger, Qin Sun, Lin Fei, and Daniel Mallon of Cincinnati Children’s Hospital