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Features of children with positive celiac serology and type 1 diabetes mellitus
Pornthep Tanpowpong1, Sarabeth Broder-Fingert2, Aubrey J Katz3
1Division of Gastroenterology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Insights
Children with celiac disease and type 1 diabetes show distinct endoscopic and histopathological findings compared to those with celiac disease alone. This suggests unique disease presentations in co-occurring conditions.
Area of Science:
- Pediatric Gastroenterology
- Endocrinology
- Immunology
Background:
- Disparate clinical presentations are noted in children with coexisting celiac disease (CD) and type 1 diabetes mellitus (T1DM) versus CD alone.
- Limited research exists on endoscopic and histopathological differences between these groups.
Purpose of the Study:
- To investigate and compare endoscopic and histopathological findings in children with CD and T1DM versus children with CD alone.
Main Methods:
- Retrospective review of children aged 2-18 years with positive celiac serology and upper endoscopy within 3 months of initial evaluation.
- Data collected included medical history, serologic markers, endoscopic findings, and histopathology.
- Comparison between children with and without diagnosed T1DM.
Main Results:
- 294 children met criteria; 21 had T1DM.
- Diabetic children were less likely to report gastrointestinal symptoms.
- Erythematous duodenal/esophageal mucosa and reflux esophagitis histopathology were more frequent in the T1DM group.
Conclusions:
- Children with coexisting celiac disease and type 1 diabetes exhibit distinct histopathological features compared to those with celiac disease alone.
- These findings highlight differences in disease presentation and potential underlying mechanisms.
Abstract:
Prior studies have reported disparate clinical presentations between children with celiac disease and type 1 diabetes mellitus and those with celiac disease alone. Studies focusing on differences in endoscopic and histopathological findings, however, are limited. We reviewed children aged 2-18 years, presenting for an initial evaluation between January 2000 and December 2010. Data on medical history, serologic markers, upper endoscopy, and histopathology were collected. Only the children with positive celiac serology who had upper endoscopy performed within 3 months of the initial visit were included. We identified 294 children who fulfilled the criteria, 21 of whom had diagnosed type 1 diabetes mellitus. Diabetic children were more likely to have absence of gastrointestinal symptoms. Erythematous duodenal and esophageal mucosa on endoscopy, and histopathology suggestive of reflux esophagitis were more common in the diabetes group. Diabetic children with positive celiac serology had different histopathological features as compared with their non-diabetic counterparts.
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