In:
Archives of Disease in Childhood, BMJ, Vol. 104, No. 4 ( 2019-04), p. 354-359
Abstract:
To investigate the frequency of coeliac disease (CD)-specific human leucocyte antigen (HLA) genotypes in paediatric patients with type 1 diabetes (T1D), who are known to have a higher prevalence of CD than the general population, and to evaluate whether HLA genotyping is a suitable first-line screening method for CD. Study design The study was a multicentre observational analysis of patients with T1D aged 〈 20 years of whom a subgroup had undergone HLA genotyping. Patient data were retrieved from the Diabetes Prospective Follow-up database, a large diabetes follow-up registry. The present analysis included data from 439 centres throughout Germany, Austria, Switzerland and Luxembourg. Results In March 2017, the database contained 75 202 patients with T1D (53% male, mean age (SD) 14.6 (4.1) years, mean age at diagnosis 8.8 (4.3) years and mean diabetes duration 5.8 (4.3) years). 1624 patients had undergone coeliac-specific HLA genotyping, of whom 1344 (82.8%) were positive for HLA-DQ2, HLA-DQ8 or both, while 17.2% had no coeliac-specific HLA-markers. 26.6% of at-risk patients had a clinical suspected diagnosis of CD, and 3.6% had biopsy-proven CD. Conclusions Genotyping for HLA-DQ2, HLA-DQ8 or both is positive in the vast majority ( 〉 80%) of patients with T1D. Therefore, screening for coeliac-specific HLA genotypes as a first-line test is not a suitable method to exclude CD in T1D. Regular screening for coeliac-specific antibodies in T1D is still recommended.
Type of Medium:
Online Resource
ISSN:
0003-9888
,
1468-2044
DOI:
10.1136/archdischild-2018-315549
Language:
English
Publisher:
BMJ
Publication Date:
2019
detail.hit.zdb_id:
1481191-1
