Recommendations for Clinical Decision-making in Children with Type 1 Diabetes and Celiac Disease: Type 1 Diabetes and Celiac Disease Joint Working Group Report

J Clin Res Pediatr Endocrinol. 2021 Aug 18. doi: 10.4274/jcrpe.galenos.2021.2021.0139. Online ahead of print.ABSTRACTIt is well-known that in children with type 1 diabetes (T1D), the frequency of celiac disease (CD) is increased due to unclear mechanisms including autoimmune injury as well as shared genetic predisposition. Although histopathologic examination is gold standard, avoiding unnecessary endoscopy is crucial. Therefore, from the perspective of the clinicians and patients' families, the diagnosis of celiac disease remains challenging. With these in mind, a joint working group (Type 1 Diabetes and Celiac Disease Joint Working Group) was gathered, with the aim of reporting institutional data, as well as the current recommendations of international organizations, in order to provide a framework for clinicians. Several controversial issues were discussed: For CD screening in children with T1D, regardless of age, it is recommended to measure tTG-IgA (tissue transglutaminase-Immunoglobulin A) and/or endomysial (EMA-IgA) antibody due to their high sensitivity and specificity. However, the decision-making process based on tTG-IgA titer in children with T1D is still debated, since tTG-IgA titers may fluctuate in children with T1D. Moreover, seronegativity may occur spontaneously. The authors' own data showed that most of the cases who have biopsy-proven CD had tTG-IgA levels 7-10 times above the upper limit. The decision of endoscopy based solely on tTG-IgA levels should be a...
Source: JCRPE Journal of Clinical Research in Pediatric Endocrinology - Category: Endocrinology Authors: Source Type: research

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Conclusion: This study suggests that cesarean delivery is not associated with the risk of hospitalization for autoimmune disorders before 14 years of age. Delivery mode does not seem to mediate the risk of autoimmunity in childhood.What is Known:• Children born by cesarean may be at risk of abnormal immune development.• The association between cesarean delivery and risk of pediatric autoimmune disorders is unclear.What is New:• In this cohort study of over 900,000 children, cesarean delivery was not associated with the risk of hospitalization for a range of autoimmune disorders before 14 years of age.• ...
Source: European Journal of Pediatrics - Category: Pediatrics Source Type: research
AbstractType 1 diabetes (T1D) is a chronic disease caused by the destruction of pancreatic β cells, which is driven by autoreactive T lymphocytes. It has been described that a high proportion of T1D patients develop other autoimmune diseases (AIDs), such as autoimmune thyroid disease, celiac disease, or vitiligo, which suggests the existence of common etiological factors among these diso rders. In this regard, genetic studies have identified a high number ofloci consistently associated with T1D that also represent established genetic risk factors for other AIDs. In addition, studies focused on identifying the shared g...
Source: Seminars in Immunopathology - Category: Pathology Source Type: research
AbstractBackgroundType I diabetes (T1D) is an autoimmune disease caused by the immune-mediated destruction of insulin-producing pancreatic β cells.. Celiac disease is 5-7 percent more common in people with T1D than in the general population.ObjectivesThe aim of this study was to detect the incidence of coeliac disease among newly diagnosed T1D children by assessment of Anti-tissue Transglutaminase Antibody (anti-tTG), IgA.MethodsFifty children with newly diagnosed T1D and another 15 age and sex –matched healthy individuals were subjected to screening for celiac disease by measuring total body IgA and antiTtg(IgA...
Source: QJM - Category: Internal Medicine Source Type: research
J Clin Res Pediatr Endocrinol. 2021 Aug 18. doi: 10.4274/jcrpe.galenos.2021.2021.0139. Online ahead of print.ABSTRACTIt is well-known that in children with type 1 diabetes (T1D), the frequency of celiac disease (CD) is increased due to unclear mechanisms including autoimmune injury as well as shared genetic predisposition. Although histopathologic examination is gold standard, avoiding unnecessary endoscopy is crucial. Therefore, from the perspective of the clinicians and patients' families, the diagnosis of celiac disease remains challenging. With these in mind, a joint working group (Type 1 Diabetes and Celiac Disease Jo...
Source: JCRPE Journal of Clinical Research in Pediatric Endocrinology - Category: Endocrinology Authors: Source Type: research
Type 1 diabetes mellitus (T1DM) is an autoimmune disorder with various micro and macro-vascular complications [1]. The link between T1DM and celiac disease (CD) has been confirmed [2], and the rate is estimated to be 4-9% [3]. Hence, the hypothesis is that there might be some immunological similarities between them [4,5].
Source: Primary Care Diabetes - Category: Primary Care Authors: Tags: Original research Source Type: research
AbstractIntroductionGut microbiota is now considered to be a hidden organ that interacts bidirectionally with cellular responses in numerous organs belonged to the immune, bone, and nervous systems. Here, we aimed to investigate the relationships between gut microbiota and complex diseases by utilizing multiple publicly available genome-wide association.Materials and methodsWe applied a novel microbiota-related gene set enrichment analysis approach to detect the associations between gut microbiota and complex diseases by processing genome-wide association studies (GWASs) data sets of six autoimmune diseases (including celi...
Source: Journal of Bone and Mineral Metabolism - Category: Orthopaedics Source Type: research
The existing knowledge about the association between NLRP3 rs35829419/rs10754558 polymorphisms and susceptibility to autoimmune diseases (AIDs) remains controversial. Herein, a meta-analysis was performed to evaluate such association. We searched databases for relevant studies published in English up to February 2021. Stata14 was used to assess the odds ratio (OR). As for NLRP3 rs35829419, no significant association to overall AIDs was found in three genetic models [A vs. C: OR (95%CI) = 0.89 (0.69–1.14); AC vs. CC: 1.00 (0.77–1.30); AA/AC vs. CC: 0.93 (0.71–1.20)]. However, subgroup analysis by disease t...
Source: Frontiers in Genetics - Category: Genetics & Stem Cells Source Type: research
Conclusions: Surgical total thyroidectomy and anti-TPO Ab-related autoimmunity appear to play a beneficial role and definitive role in the remission of AAI in HT.
Source: Nigerian Journal of Clinical Practice - Category: Rural Health Authors: Source Type: research
Type 1 diabetes mellitus could be associated with other autoimmune diseases, such as autoimmune thyroid disease, celiac disease, but the association with Familial Mediterranean Fever is rare, we describe a cas...
Source: Italian Journal of Pediatrics - Category: Pediatrics Authors: Tags: Case report Source Type: research
CONCLUSION: Patients with autoimmune type 1 diabetes mellitus should undergo screening for other autoimmune diseases, most importantly, autoimmune thyroid disease, pernicious anaemia and may be hyperhomocysteinaemia and primary adrenal insufficiency.PMID:34010447 | DOI:10.5603/EP.a2021.0035
Source: Endokrynologia Polska - Category: Endocrinology Authors: Source Type: research
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