Serum Immunoglobulin A Anti-Endomysial Antibody (IgA-EMA) and its Effectiveness in Screening for Celiac Disease in the Pediatric Population with Diabetes Mellitus 1

INTRODUCTION: Diabetes Mellitus Type 1 (DM 1) and celiac disease (CD) are both autoimmune diseases that are associated with the human leukocyte antigen (HLA)-DQ2 and human leukocyte antigen (HLA)-DQ8 genetic halotypes. Different geographical areas vary with prevalence of CD in populations with DM 1, ranging from 1.1% to 16.4%. Type 1 diabetes is a chronic autoimmune disease and accounts for approximately two thirds of all new diagnoses of diabetes in patients 19 years of age and younger, with a continue rise in incidence. Celiac disease is also an autoimmune disorder, and is characterized by intestinal villous damage caused by gluten ingestion. In the United States and Western Europe, the prevalence is approximately 1%. Individuals are susceptible to celiac disease on average, within 10 years of their DM 1 diagnosis. The incidence of celiac disease is increasing in those with type 1 diabetes because screening for CD has been made possible with the availability of non-invasive serological testing. Immunoglobulin A antiendomysial antibody (IgAEMA) has high sensitivity and specificity for celiac disease and has been proven to be effective in diagnosing atypical and latent CD. However, the “gold” standard for celiac diagnosis is the intestinal biopsy. METHODS: The focus of this study was to review the current literature on all studies pertaining to IgA-EMA screening for celiac disease in the pediatric population with type 1 diabetes. The studies involved screening of type 1 diabetic patients for celiac disease with IgAEMA and intestinal biopsies for those who tested positive for IgAEMA. RESULTS: The seven studies showed high prevalence of celiac disease in pediatric individuals with type 1 diabetes. Several studies also demonstrated that those who were initially negative for celiac disease later developed latent celiac disease. CONCLUSION: IgA-EMA is an effective screening test for celiac disease in individuals with type 1 diabetes. The studies reported that due to the high prevalence of celiac disease in conjunction with type 1 diabetes, initial screening for celiac disease at diabetes onset is recommended and should be performed. They also stated that since seroconversion could occur, and patients could develop latent celiac disease, screening for celiac disease should also be performed after diabetes onset. How often and at what interval screening should be done is unanswered. Degree Type Capstone Project Rights Terms of use for work posted in CommonKnowledge. This capstone project is available at CommonKnowledge: http://commons.pacificu.edu/pa/158 Copyright and terms of use If you have downloaded this document directly from the web or from CommonKnowledge, see the “Rights” section on the previous page for the terms of use. If you have received this document through an interlibrary loan/document delivery service, the following terms of use apply: Copyright in this work is held by the author(s). You may download or print any portion of this document for personal use only, or for any use that is allowed by fair use (Title 17, §107 U.S.C.). Except for personal or fair use, you or your borrowing library may not reproduce, remix, republish, post, transmit, or distribute this document, or any portion thereof, without the permission of the copyright owner. [Note: If this document is licensed under a Creative Commons license (see “Rights” on the previous page) which allows broader usage rights, your use is governed by the terms of that license. ] Inquiries regarding further use of these materials should be addressed to: CommonKnowledge Rights, Pacific University Library, 2043 College Way, Forest Grove, OR 97116, (503) 352-7209. Email inquiries may be directed to:. copyright@pacificu.edu This capstone project is available at CommonKnowledge: http://commons.pacificu.edu/pa/158 NOTICE TO READERS This work is not a peer-reviewed publication. The Master’s Candidate author(s) of this work have made every effort to provide accurate information and to rely on authoritative sources in the completion of this work. However, neither the author(s) nor the faculty advisor(s) warrants the completeness, accuracy or usefulness of the information provided in this work. This work should not be considered authoritative or comprehensive in and of itself and the author(s) and advisor(s) disclaim all responsibility for the results obtained from use of the information contained in this work. Knowledge and practice change constantly, and readers are advised to confirm the information found in this work with other more current and/or comprehensive sources. The student authors attest that this work is completely their original authorship and that no material in this work has been plagiarized, fabricated or incorrectly attributed.