TY  - JOUR
TI  - Recommendations for Clinical Decision-making in Children with
Type 1 Diabetes and Celiac Disease: Type 1 Diabetes and Celiac
Disease Joint Working Group Report
AB  - It is well-known that in children with type 1 diabetes (T1D), the frequency of Celiac disease (CD) is increased due to mechanisms which
are not fully elucidated but include autoimmune injury as well as shared genetic predisposition. Although histopathologic examination
is the gold standard for diagnosis, avoiding unnecessary endoscopy is crucial. Therefore, for both clinicians and patients’ families,
the diagnosis of CD remains challenging. In light of this, a joint working group, the Type 1 Diabetes and Celiac Disease Joint Working
Group, was convened, with the aim of reporting institutional data and reviewing current international guidelines, in order to provide
a framework for clinicians. Several controversial issues were discussed: For CD screening in children with T1D, regardless of age, it
is recommended to measure tissue transglutaminase-immunoglobulin A (tTG-IgA) and/or endomysial-IgA antibody due to their high
sensitivity and specificity. However, the decision-making process based on tTG-IgA titer in children with T1D is still debated, since tTGIgA
titers may fluctuate in children with T1D. Moreover, seronegativity may occur spontaneously. The authors’ own data showed that most of the cases who have biopsy-proven CD had tTG-IgA levels 7-10 times above the upper limit. The decision for endoscopy based
solely on tTG-IgA levels should be avoided, except in cases where tTG-IgA levels are seven times and above the upper limit. A closer
collaboration should be built between divisions of pediatric endocrinology and gastroenterology in terms of screening, diagnosis and
follow-up of children with T1D and suspicious CD.
AU  - Kuloglu, Zarife
AU  - Evliyaoğlu, Olcay
AU  - DOGAN, YASAR
AU  - Hatun, Sukru
AU  - Ozbek, Mehmet Nuri
AU  - SAVAS ERDEVE, SENAY
AU  - Darendeliler, Feyza
AU  - KESER, Alev
AU  - Dalgıç, Buket
AU  - Beser, Omer
AU  - aycan, zehra
AU  - Aydogdu, Sema
AU  - gökşen, damla
AU  - KOCA, Tugba
AU  - KIZILKAN, Nuray Uslu
AU  - yesiltepe mutlu, gül
AU  - Selimoglu, Mukadder Ayse
AU  - Ertem, Deniz
AU  - ELİUZ TİPİCİ, BEYZA
AU  - Bas, Firdevs
AU  - Bideci, Aysun
DO  - 10.4274/jcrpe.galenos.2021.2021.0139
PY  - 2022
JO  - Journal of Clinical Research in Pediatric Endocrinology
VL  - 14
IS  - 1
SN  - 1308-5727
SP  - 1
EP  - 9
DB  - TRDizin
UR  - http://search/yayin/detay/515943
ER  -