Original Article

Frequency of Celiac Disease and Spontaneous Normalization Rate of Celiac Serology in Children and Adolescent Patients with Type 1 Diabetes


  • Edip Unal
  • Meliha Demiral
  • Birsen Baysal
  • Mehmet Agın
  • Elif Gökçe Devecioğlu
  • Hüseyin Demirbilek
  • Mehmet Nuri Özbek

Received Date: 17.05.2020 Accepted Date: 14.08.2020 J Clin Res Pediatr Endocrinol 0;0(0):0-0 [e-Pub] PMID: 32820875


The prevalence of celiac disease (CD) varies between 1% and 10% in patients with type 1 diabetes mellitus(T1DM). This study aims to determine the frequency of spontaneous recovery of celiac serology and the biopsy-proven CD frequency (BPCD) in patients with T1DM.


The data of 668 patients with celiac serology from 779 patients who were followed for the last 10 years with the diagnosis of T1DM were retrospectively evaluated.


Positive serology was detected in 103 out of 668(15.4%) patients. There was spontaneous normalization in 24(23.3%), fluctuation in 11(10.7%) and permanently positive serology in 68(66%) of these patients. In 46 out of 53(86.8%) patients with positive serology diagnosis of CD was confirmed with a biopsy (BPCD). The frequency of BPCD was 6.9%, and the serology in 76.1% of them was positive at the time of the diagnosis of T1DM. The weight, height and BMI-SDS at the time of diagnosis were lower in patients with BPCD compared to the group without CD. The anti-tissue transglutaminase-IgA level of 11.8 times higher than the upper limit of normal revealed the best sensitivity (93%) and specificity (90%) for BPCD (AUC:0.95; 95% CI: 0.912-1; p<0.001).


In our cohort, the frequency of positive serology for CD was 15.4%, while the rate of BPCD was 6.9%. The majority (97.8%) of cases were diagnosed within the first five years of T1DM. In 23.3% of cases, positive anti-TTG-IgA spontaneously resolved without a gluten-free diet. Therefore, serological follow-up instead of immediate duodenal biopsy or gluten-free diet therapy, particularly for patients with asymptomatic and mild anti-TTG IgA level, is warranted.

Keywords: Celiac disease, children, spontaneous normalization, type 1 diabetes