Do patients with celiac disease patients differ from those with concurrent celiac disease with type 1 diabetes mellitus?

Abstract

Background and objectives Celiac disease (CD) and type 1 diabetes mellitus (T1DM) share common genetic loci. Patients with T1DM developing CD may remain asymptomatic and some of the common symptoms of CD may be considered as part of the chronic complications of diabetes like gastrointestinal intolerance, diarrhea, nocturnal diarrhea, alternate diarrhea and constipation. There are no reports on comparison of presenting features of patients with CD and those with CD and T1DM together. The present study was planned to compare clinical, biochemical and hormonal profile of patients of CD and CD with T1DM. Patients and methods Consecutive CD patients with and without T1DM ≤ 20 years seen by us were evaluated clinically and underwent thyroid, gonadal function tests (where applicable) and serum cortisol, besides routine hemogram and biochemical tests. Patients were subjected to screening for CD by anti tissue transglutaminase antibodies (tTGAb) and those positive were subjected to endoscopy of descending part of the duodenum, and 3 biopsies were taken. Histological interpretation was done by an experienced pathologist and recorded as per modified Marsh classification [1]. Patients were diagnosed to have CD as per modified ESPGHAN criteria [2] and T1DM as per ADA position statement [3]. All patients received gluten free diet (GFD) and / or diabetic diet. Patients with CD alone (group A) were compared with those having CD with T1DM (Group B). Results 109 patients (57 males) with mean age of 14.9±2.9 year fulfilled the eligibility criteria. 23 (21.1%) had T1DM