The use of IgA-antiendomysial antibody test for screening coeliac disease in insulin-dependent diabetes mellitus

The co-existence of coeliac disease (CD) and insulin-dependent diabetes mellitus (IDDM) was investigated using a specific recently described test: the IgA-antiendomysial antibody (EmA). All 138 ID diabetics living in the province of Bergamo and ranging 0-20 yr (mean 13.1; 54 females, 84 males; mean duration of IDDM 5.7 yr, range 1-18), whose data had been carefully derived from multiple sources, were screened over a period of six months, IgA-EmA, antigliadin IgA and IgG (AGA) and HbA(1C) were measured, Control serum samples for the same determinations were obtained from 91 subjects without intestinal problems, Student's t test and Chi-square analysis were applied, Four diabetic patients had been previously diagnosed as having biopsy proven CD, They were IgG-AGA and EmA positive at the onset of CD, Two clinically silent diabetic patients were both AGA and EmA positive; they underwent intestinal biopsy and villous atrophy was found, Twenty-two CD symptom-free EmA negative diabetics (16.6%) were IgG-AGA positive vs 5 cases of control group (5.5%) (p<0.05). The prevalence of CD in our patients (4.35%) was similar to that found in IDDs of other countries and higher than in the general population; so we suggest that IDD patients be screened routinely for CD, IgA-EmA was confirmed to be a reliable serological marker in assisting CD diagnosis and deciding which patients to biopsy. (C) 1996, Editrice Kurtis.