J Rutsky et al. JPGN 2024;79:622–630. Open Access! Predictors of celiac disease in patients with type 1 diabetes and positive tissue transglutaminase immunoglobulin A

This was a retrospective single-center study with 123 patients -60% had biopsy-proven celiac disease (CD).

Key findings:

• Higher titers were more likely to be associated with CD. The degree of TTG IgA elevation in patients with T1DM is correlated with the risk of CD; for every 10‐fold increase in TTG IgA, there is a 4.7× increased risk of celiac diagnosis.
• However, even with TTG IgA >10 x ULN, only 85% had CD.

My take: Currently, the non-biopsy approach for CD diagnosis should not be used in patients with type 1 diabetes mellitus.

Related blog posts:

• Celiac Disease: Pro Tips (Part 1)
• Why Celiac Serology Needs To Be Looked At Differently in Children with Type 1 Diabetes
• Celiac Diseaase and Diabetes
• Reappraisal of the Risk of Autoimmune Disease with Celiac, Plus One
• Celiac Disease: Pro Tips (Part 2)
• Celiac Disease: Pro Tips (Part 3)
• Celiac Disease: Pro Tips (Part 4)
• No-Biopsy Approach to Celiac Disease Diagnosis and Positive Predictive Value (Based on Population)
• ESPGHAN Guidelines for Diagnosing Coeliac Disease 2020