Clinical profile and association of Celiac Disease in children with type-1 Diabetes Mellitus
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Abstract
OBJECTIVE: To find out the clinical profile and association of Celiac Disease (CD) in children with established type-1 Diabetes Mellitus (T1DM) presenting in a tertiary care hospital of Karachi, Pakistan.
METHODS: This cross-sectional study was conducted from January-2019 to July-2019 at National Institute of Child Health, Karachi, Pakistan. A total of 126 T1DM patients of age 1-18 years were subjected to detailed history and clinical examination for CD except those in diabetic ketoacidosis and having pancreatic calcifications. Blood sample was drawn from the patients for Tissue Transglutaminase (tTg) Immunoglobulin A (IgA) and tTg Immunoglobulin G (IgG) levels and Anti-Deamidated Gliadin Peptide (anti-DGP) IgG was estimated using commercially available Enzyme Linked Immunosorbant Assay.
RESULTS: Twenty-nine (23.0%) patients were diagnosed as CD based on positive serology. The mean age of the patients was 9.31±4.40 years, 70 (55.6%) were male and 56 (44.4%) patients were female. Out of 126 T1DM patients, 29 (23.0%) were diagnosed with CD. Raised anti-DGP IgG levels were observed in 39 (30.95%) patients, raised anti-tTg-IgA levels in 35 (27.78%) and raised Anti-tTg IgG level in 36 (28.57%) cases. Other associated features included anemia (n=85; 67.46%), vomiting (n=50; 39.6%), abdominal distension (n=37; 29.3%), diarrhea (n=30; 23.81%) and abdominal pain (n=26; 20.6%).
CONCLUSION: CD is relatively common in children with T1DM, affecting both genders. Specific serological markers proved significant in CD identification. This study highlights associated features like anemia and gastrointestinal symptoms, emphasizing the need for careful consideration of CD in T1DM patients.
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