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. 2021 Jul 1;116(7):1545-1549.
doi: 10.14309/ajg.0000000000001193.

Accuracy of Screening Tests for Celiac Disease in Asymptomatic Patients With Type 1 Diabetes

Michelle J Gould  1 , Farid H Mahmud  2 , Antoine B M Clarke  2 , Charlotte McDonald  3 , Fred Saibil  4 , Zubin Punthakee  5 , Margaret A Marcon  1
Affiliations

Accuracy of Screening Tests for Celiac Disease in Asymptomatic Patients With Type 1 Diabetes

Michelle J Gould et al. Am J Gastroenterol. .

Abstract

Introduction: To evaluate the diagnostic performance of celiac serologic tests in asymptomatic patients with type 1 diabetes (T1D).

Methods: Patients with T1D asymptomatic for celiac disease were prospectively screened with immunoglobulin A anti-tissue transglutaminase. Test characteristics were calculated and optimal cutoffs for a positive screen determined.

Results: Two thousand three hundred fifty-three patients were screened and 101 proceeded to biopsy. The positive predictive value of immunoglobulin A anti-tissue transglutaminase at the assay referenced upper limit of normal (30CU) was 85.9%, and the sensitivity and specificity were 100% and 38%, respectively.

Discussion: Thresholds extrapolated from the general population for the diagnostic evaluation of celiac disease are not suitable for use in asymptomatic T1D patients. Population-specific screening cutoffs are required.

Trial registration: ClinicalTrials.gov NCT01566110.

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