β-cell autoimmunity in pediatric celiac: the case for routine screening?

  1. Giuseppe d'Annunzio, MD (giuseppedannunzio{at}ospedale-gaslini.ge.it)1,
  2. Alessandro Giannattasio, MD1,
  3. Elena Poggi, MD1,
  4. Emanuela Castellano, MD2,
  5. Angela Calvi, MD2,
  6. Angela Pistorio, MD3,
  7. Arrigo Barabino, MD2 and
  8. Renata Lorini, MD1
  1. 1University of Genova, Department of Pediatrics, IRCCS G. Gaslini Institute, Genoa, Italy
  2. 2Department Service of Gastroenterology, IRCCS G. Gaslini, Genoa, Italy, G. Gaslini Institute, Genoa, Italy
  3. 3Epidemiology and Biostatistics Unit, IRCCS G. Gaslini Institute, Genoa, Italy

    Abstract

    Objective: To evaluate the prevalence of β-cell autoimmunity, and the usefulness of screening procedure in patients with celiac disease (CD).

    Research design and methods: We measured GADA, IA-2A and IAA in 188 CD young Italian patients (66 males, 35.1%); mean age at CD diagnosis was 5.4 years (0.5-17.1 yrs) and mean CD duration was 4.2 years (0-28.8 yrs). CD was diagnosed by jejunal biopsy, after confirmed positivity for EMA and tTGA.

    Results: GADA were positive in 7 patients (3.7%), and IA-2A were positive in 2 patients. IAA were negative in all cases. Metabolic evaluation was normal, and no patient developed diabetes mellitus during follow-up. No significant association between β-cell autoimmunity and gender, age, puberal stage, family history or coexistence of other autoimmune disorders, compliance to gluten-free diet was found.

    Conclusions: Our results showed a low prevalence of β-cell autoimmunity and don't support its precocious screening in young CD patients.

    Footnotes

      • Received August 13, 2008.
      • Accepted November 4, 2008.