Delayed presentation of seropositivity in pre-existent coeliac disease in patients with Type 1 diabetes mellitus: a possible co-occurrence?

E. Kostopoulou, M. Lagadinou, A. Avgeri, A. Varvarigou

Department of Paediatrics, University of Patras Medical School and University General Hospital of Patras, Patras, Greece. irekost@upatras.gr

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• Pediatrics

OBJECTIVE: The co-occurrence of coeliac disease (CD) and type 1 diabetes mellitus (T1DM) is well described and is mainly explained by sharing of common pathogenic mechanisms, such as common high-risk human lymphocyte antigen (HLA) genotypes (DR-DQ).

PATIENTS AND METHODS: We describe a 12-year-old female patient with T1DM who presented with prolonged and severe glucose dysregulation. Extensive investigations, including coeliac screen, were negative.

RESULTS: 3 years after glucose dysregulation manifested, coeliac screen testing was positive and coeliac disease was confirmed with bowel biopsy. Compliance to a gluten-free diet resulted in improvement of glucose control and seronegativity 9 months post-diagnosis.

CONCLUSIONS: This is the first case report describing delayed seropositivity of CD and suggests that CD enteropathy may precede positive serology and could cause severe glucose dysregulation in patients with T1DM.

 

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