Type 1 Diabetes and Celiac Disease: Can (and Should) We Raise the Cut-off of Tissue Transglutaminase Immunoglobulin A to Decide Whether to Biopsy?

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Celiac disease prevalence is high and increasing worldwide, albeit with wide regional variations around the globe.1,2 The prevalence seems to be significantly greater in children than in adults (0.9% vs 0.5%; P < .001).2 In addition, there is a well-known association with other autoimmune diseases, with which celiac disease shares common HLA-associated genes.3 Perhaps the best known association is with type 1 diabetes (T1DM). In fact, patients with T1DM have a high prevalence of a number of other autoimmune diseases, including autoimmune thyroid disease, gastric autoimmunity with pernicious anemia, vitiligo, and adrenal gland insufficiency.

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