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Updated: Jun 27, 2025
A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19
Published on: July 5, 2022
Home capillary sampling and screening for type 1 diabetes, celiac disease, and autoimmune thyroid disease in a
Maria Naredi Scherman1,2, Alexander Lind1, Samia Hamdan1
1Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
Insights
Home capillary sampling effectively screened Swedish schoolchildren for autoimmune diseases. The study identified significant rates of autoimmunity and undiagnosed type 1 diabetes, celiac disease, and autoimmune thyroid disease.
Area of Science:
- Pediatric Autoimmunity
- Public Health Screening
- Molecular Diagnostics
Background:
- Type 1 diabetes (T1D), celiac disease (CD), and autoimmune thyroid disease (AITD) are common autoimmune conditions in children.
- Early detection and intervention are crucial for managing these diseases and preventing complications.
- Home-based sampling offers a convenient method for widespread pediatric screening.
Purpose of the Study:
- To evaluate the feasibility and yield of screening a general pediatric population for T1D, CD, and AITD using home capillary blood sampling.
- To determine the prevalence of autoantibodies and diagnosed autoimmune diseases within the screened population.
Main Methods:
- A cohort of Swedish schoolchildren (6-9 and 13-16 years) was invited to self-collect capillary blood samples at home.
- Samples were analyzed for autoantibodies associated with T1D, CD, and AITD.
- Children with persistent autoantibodies underwent clinical follow-up for diagnosis.
Main Results:
- Of 19,593 invited, 2,271 children (11.6%) were included in the analysis.
- Persistent autoantibodies were found in 9.3% of participants (T1D: 2.6%, CD: 2.7%, AITD: 4.4%).
- Undiagnosed T1D, CD, and AITD were diagnosed in 0.1%, 1.1%, and 0.3% of children, respectively, totaling 1.5% with newly detected disease.
Conclusions:
- Home capillary sampling is a viable strategy for screening pediatric populations for T1D, CD, and AITD.
- The screening identified a notable percentage of children with autoimmunity and undiagnosed autoimmune conditions.
- Children with a family history of these diseases showed a higher prevalence of autoantibodies and diagnosed conditions.
Objective:
To screen a general pediatric population for type 1 diabetes (T1D), celiac disease (CD), and autoimmune thyroid disease (AITD) after home capillary sampling.
Methods:
Swedish schoolchildren between 6-9 years and 13-16 years of age were invited to screening by taking a capillary sample at home. Samples were returned by mail and assessed for autoantibodies associated with T1D, CD, and AITD. Persistently autoantibody-positive children were referred for clinical follow-up.
Results:
Of 19,593 invited, 3,527 (18.0%) consented to participate and 2,315/3,527 (65.6%) returned a blood sample of sufficient volume. Hemolysis occurred in 830/2,301 (36.1%) samples. After exclusion of 42 children with previously known T1D, CD, or AITD, and two autoantibody-positive children who declined a confirmatory sample, 2,271/19,593 (11.6%) were included. 211/2,271 (9.3%) had persistent autoantibodies: 60/2,271 (2.6%) with T1D autoantibodies, 61/2,271 (2.7%) with CD autoantibodies, and 99/2,271 (4.4%) with AITD autoantibodies; 9/2,271 (0.4%) were autoantibody positive for ≥1 disease. After clinical follow-up, 3/2,271 (0.1%) were diagnosed with T1D, 26/2,271 (1.1%) with CD, and 6/2,271 (0.3%) with AITD. Children with a first-degree relative (FDR) with T1D, CD, and/or AITD, had higher occurrence of autoantibodies compared to children without an FDR (63/344, 18.3%, vs. 148/1,810, 8.2%) (p < 0.0001, OR 2.52, 95% CI 1.83-3.47), and higher occurrence of screening-detected diagnosis (14/344, 4.1%, vs. 21/1,810, 1.2%) (p < 0.0001, OR 3.61, 95% CI 1.82-7.18). Half of these children screened positive for another disease than the FDR.
Conclusion:
Screening for T1D, CD, and AITD by home capillary sampling in a Swedish general pediatric population detected autoimmunity in 9.3% and undiagnosed disease in 1.5%.
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