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Abstract : |
Coeliac disease is diagnosed in 5% of patients with diabetes mellitus type 1 (DM 1). Its clinical manifestation is usually latent or subclinical. The coincidence of both diseases is more common when diabetes was diagnosed in early childhood (under the age of 4). In order to prevent severe complications of not diagnosed coeliac disease it is recommended to make a screening in all patients with DMl and their first degree family members. The diagnostic methods of choice are immunological tests including antitransglutaminase antibodies and antiendomysium antibodies in class IgA. If the serological tests at the screening time are negative it is recommended to repeat them each year for at least 4 years since the moment when diabetes was diagnosed. In patients with coeliac disease also exocrine pancreatic insufficiency is observed in 10 to 100% cases and thisfactcould be responsible for some cases of refractory to gluten-free diet coeliac disease. Pancreatic insufficiency is a result of impaired cholecystokinin and secretin release as well as protein malnutrition. Taking into consideration high prevalance of macroamylase in patients with coeliac disease it is recommended to consider possibility of coeliac disease in a case of hyperamylasemia without evidence of pancreatitis., |
