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. 2022 Jan;9(1):e000735.
doi: 10.1136/bmjgast-2021-000735.

Role of HLA-DQ typing and antitissue transglutaminase antibody titres in diagnosing coeliac disease among Sudanese children with type 1 diabetes mellitus

Ibtihag Ibaid  1 , Mohammed Hussien  2 , Katri Kaukinen  3   4 , Omayma Sabir  5   6 , Miskelyemen Elmekki  7 , Azza Musa  8 , Nasreldein Abdelhadi  9 , Abdel Rahim El Hussein  2   10 , Päivi Saavalainen  11
Affiliations

Role of HLA-DQ typing and antitissue transglutaminase antibody titres in diagnosing coeliac disease among Sudanese children with type 1 diabetes mellitus

Ibtihag Ibaid et al. BMJ Open Gastroenterol. 2022 Jan.

Abstract

Objective: The aim of the study was to determine the prevalence of coeliac disease (CD) and to recognise Human leukocyte antigen (HLA)-associated hereditary susceptibility to Sudanese CD patients with type 1 diabetes mellitus (DM1).

Design: Antitissue transglutaminase IgA (anti-TG IgA) was measured in the serum of 373 children affected with DM1 aged 1-19-year old and in 100 serum samples from non-diabetic control children. Histological examination was performed in 19 children seropositive for anti-TG IgA (17 DMI and 2 controls). Additionally, PCR-based analysis of Major histocompatibility complex, class II, DQ beta 1 (HLA-DQB1) genotyping was implemented in three study population groups as follows: group 1 (n=25) (+ve DM1 and +ve CD), group 2 (n=63) (-ve DM1 and +ve CD) and control group 3 (n=2) (+ve CD).

Results: Twenty-six Sudanese children with DM1 out of 373 (6.97%) were seropositive for anti-TG IgA. Duodenal biopsy revealed Marsh 2 and 3 in 13 out of 17 (76.47%) seropositive anti-TG IgA patients with DM1. Significant association (p<0.05) was detected between the level of anti-TG IgA autoantibodies (IU/mL) and Marsh stage. HLA DQ2 and DQ8 were found in 88% (22/25) and 8% (2/25) of examined patients with CD with DM1, respectively.

Conclusions: Anti-TG IgA titre of greater than 10 times upper limit of normal (≥10× ULN) can be useful for detecting CD in children with type 1 diabetes without duodenal biopsy. HLA testing in children with DM1 appears to provide little added benefit given the high prevalence (96%) of HLA DQ2/DQ8 in children with DM1.

Keywords: celiac disease; nutrition; paediatric gastroenterology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
The prevalence of anti-TG IgA in patients with Marsh 2 (n=4), 3 a (n=1), 3b (n=4), 3c (n=4), 0 (n=2) and 1 (n=2) lesions. The numbers above the graph indicate mean and SE of mean. n: number of subjects. *Significant difference.
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