Abstract:
Background. International literature has shown the prevalence of coeliac disease (CD) in children and adolescents with diabetes to range
from 1 - 10%. Prevalence rates in African countries are limited or unknown.
Objective. The objective was to describe the prevalence of CD in all children and adolescents with type 1 diabetes mellitus presenting to
the paediatric and adult diabetic clinic at Steve Biko Academic Hospital, Pretoria, South Africa.
Method. A retrospective review of the files of all children and adolescents in the paediatric and adult diabetic clinic with type 1
diabetes mellitus between August 2016 and June 2019 was conducted. Children requiring screening and/or intestinal biopsies were also
prospectively included during this period. The setting of this study was Steve Biko Academic Hospital, a tertiary referral centre, in Pretoria,
South Africa. Coeliac screening included anti-deaminated gliadin antibodies and anti-tissue transglutaminase antibodies (both IgA and
IgG). All biopsies were obtained by a paediatric gastroenterologist or an experienced paediatric surgeon.
Results. A total of 184 files were screened; 132 met inclusion criteria but only 108 patients in total had coeliac screening. Positive antibody
screening for CD was found in 11 out of 108 patients (10.2%). Nine of the 11 serology-positive patients had biopsies performed. Out of the
nine biopsies, two (22.2%) were positive for CD based on the Marsh-Oberhuber classification.
Conclusion. This study found a prevalence of serology-positive CD in our local population of South African children with type 1 diabetes
mellitus of 10.2%, while the prevalence of biopsy-confirmed CD was found to be 1.9%.
