Coeliac disease in Iraqi type 1 diabetic patients

High prevalence rates of coeliac disease (CD) in patients with type 1 diabetes mellitus (T1DM) have been reported. The aim of this study was to evaluate the frequency of silent CD in a sample of Iraqi patients with T1DM.

This is a cross-sectional study done in Baghdad Teaching Hospital, Baghdad Medical City, Baghdad, Iraq, on 62 patients with T1DM. For all patients, immunoglobulin A (IgA) anti-tissue transglutaminase antibodies (IgA tTG), IgG anti-tissue transglutaminase antibodies (IgG tTG), IgA endomysial antibody (IgA EMA), IgA antigliadin antibodies (IgA AGA) and IgG antigliadin antibodies (IgG AGA) tests were done, with duodenoscopy, and at least four biopsies were taken from the second part of the duodenum.

A total of 27 patients (43.5%) had normal small-intestinal histopathology (Marsh 0), one of them had a positive result for all serological markers used in the study, and another patient was positive for IgA tTG only. Ten patients (16.1%) had Marsh grade I, one of them was positive for IgA tTG, IgG tTG and IgA EMA, another patient was IgA deficient and had positive IgG tTG only and another patient with Marsh I had positive IgA tTG and IgG tTG only. Two patients (3.2%) had Marsh IIIA; three patients (4.8%) had Marsh IIIB histopathology, two of them were positive for all tests and one had positive IgA tTG and IgA EMA only. Two patients (3.2%) had Marsh IIIC histopathological features; they were positive for all serological tests, hence, the frequency of CD was 11.2%.

The frequency of silent CD in Iraqi patients with T1DM is not rare, reaching up to 11.2%. Both EMA and tTG antibodies are useful as screening tests.