Coeliac screening in a Scottish cohort of children with type 1 diabetes mellitus: is DQ typing the way forward?. Issue 3 (30th December 2015)

• Record Type: Journal Article
• Authors: Mitchell, R T; Sun, A; Mayo, A; Forgan, M; Comrie, A; Gillett, P M
• Is Part Of: Archives of disease in childhood. Volume 101:Issue 3(2016)
• Page Start: 230
• Page End: 233
• Publication Date: 2015-12-30
• Subjects: Coeliac Disease -- Human Leucocyte Antigen -- Screening -- Type 1 Diabetes Mellitus; Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2015-309754
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Background: Children with type 1 diabetes mellitus (T1DM) are at increased risk of coeliac disease (CD). Recent guidelines indicate coeliac screening should include HLA typing for CD predisposing (DQ2/DQ8) alleles and those negative for these alleles require no further coeliac screening. Methods: Children (n=176) with T1DM attending clinics across two Scottish regions were screened for HLA DQ2/DQ8 as part of routine screening. Data collected included the frequency of DQ2/DQ8 genotypes and the additional cost of HLA screening. Results: Overall, DQ2/DQ8 alleles were identified in 94% of patients. The additional cost of HLA typing was £3699.52 (£21.02 per patient). All patients with known CD (11/176) were positive for DQ2/DQ8 and all were diagnosed with CD within 5 years of T1DM diagnosis. Conclusions: The vast majority of children with T1DM have CD-predisposing HLA genotypes limiting the number of patients that can be excluded from further screening. We conclude that HLA genotyping is not currently indicated for CD screening in this population.