Resumen

KARSAS, M; TERBLANCHE, A J; KEMP, T  y  VAN DYK, J C. Prevalence of coeliac disease in children and adolescents with type 1 diabetes mellitus in a tertiary hospital in South Africa. S. Afr. j. child health [online]. 2021, vol.15, n.4, pp.212-217. ISSN 1999-7671.  http://dx.doi.org/10.7196/SAJCH.2021.v15i4.1841.

BACKGROUND. International literature has shown the prevalence of coeliac disease (CD) in children and adolescents with diabetes to range from 1 - 10%. Prevalence rates in African countries are limited or unknown. OBJECTIVE. The objective was to describe the prevalence of CD in all children and adolescents with type 1 diabetes mellitus presenting to the paediatric and adult diabetic clinic at Steve Biko Academic Hospital, Pretoria, South Africa. METHOD. A retrospective review of the files of all children and adolescents in the paediatric and adult diabetic clinic with type 1 diabetes mellitus between August 2016 and June 2019 was conducted. Children requiring screening and/or intestinal biopsies were also prospectively included during this period. The setting of this study was Steve Biko Academic Hospital, a tertiary referral centre, in Pretoria, South Africa. Coeliac screening included anti-deaminated gliadin antibodies and anti-tissue transglutaminase antibodies (both IgA and IgG). All biopsies were obtained by a paediatric gastroenterologist or an experienced paediatric surgeon. RESULTS. A total of 184 files were screened; 132 met inclusion criteria but only 108 patients in total had coeliac screening. Positive antibody screening for CD was found in 11 out of 108 patients (10.2%). Nine of the 11 serology-positive patients had biopsies performed. Out of the nine biopsies, two (22.2%) were positive for CD based on the Marsh-Oberhuber classification. CONCLUSION. This study found a prevalence of serology-positive CD in our local population of South African children with type 1 diabetes mellitus of 10.2%, while the prevalence of biopsy-confirmed CD was found to be 1.9%.

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