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Background: We have previously shown that EMA (endomysial antibody) and TTG (tissue transglutaminase) correlate with intestinal damage grade at diagnosis in CD children without DM. We assessed the correlation between HbA1C, albumin, hemoglobin, transaminases, BMI, TTG and EMA in different degrees of intestinal damage at time of CD diagnosis in children with DM. Design: Retrospective review of patients seen at CHOP between 1/02 and 6/06 revealed 56 children (33 girls, 23 boys; age 11.2 +/- 4.5 yrs, range 3.2-18.5 yrs) who had laboratory evaluation, TTG and EMA performed at time of histologic CD diagnosis. All children were stratified for histologic damage according to Marsh classification. Results: Marsh (M) I lesions were seen in 1 (1.8%), MII in 2 (3.6%), MII/ in 53 (94.6%) {IIIa(23.2%), IIIb(25%), IIIc(46.4%)}. TTG testing was positive in all but one and EMA testing was positive in all but two children. Mean TTG values were 186, 199, 390 in MIIIa-c, respectively; a positive trend was seen but results were not significant (p=0.11). Mean +EMA dilutions were 247, 425, 395; IIIa lower than b or c, a positive trend but not significant (p=0.32). Mean BMI% were 72, 55, 69; IIIa better than IIIb or c but not significant (p=0.15). Mean hgb were 13.9, 13.9, 13; (p=0.21) and mean MCV were 86.9, 82.9, 82.1; (p=0.22). Both values correlated with grade but values not significant. Mean HbA1C were 8.1, 8.1, 7.8; (p=0.70). ALT and AS T values were not different between groups. Hypoalbuminemia (seen in 8%), microcytic anemia (4%) and hepatitis (4%) did not differ between MIIIa-c groups. Conclusion: 95% of children with DM had severe villous blunting at diagnosis of screening detected CD. TTG and EMA mean values tend to be higher, though not significantly, in CD children with severe blunting (MIIIb and MIIIc) than in those with mild blunting (MIIIa). BMI percentile, hemoglobin, and MCV also positively correlated with degree of damage but did not reach statistical significance. HbA1C and transaminases did not correlate with degree of damage. Unlike CD children without DM, those with CD and DM appear to have loose correlation of serology, BMI%, hemoglobin, and MCV with histologic grade at CD diagnosis. [ABSTRACT FROM AUTHOR]

The article highlights a study on the antecedents of the diagnosis of screening-detected celiac disease (CD) and the effect of a gluten-free diet (GFD) in Type 1 diabetic children. The body mass index (BMI), height and HbA1c of 22 children with CD and diabetes mellitus (DM) were compared to a group of diabetic controls. It was found that BMI, height and HbA1C were similar between children with CD and the controls and GFD did not influence the measured parameters.