Our 10 year old daughter, who has had diabetes for 3 1/2 years, was tested for celiac disease due to some stomachaches she was having. The test that was performed was the antiendomyosial antibody test. The results were negative. Does this mean she will never develop celiac, or just that she doesn’t have it at this time? Also, are there any tests which can be performed to predict whether or not she will develop other autoimmune diseases?

Type 1A or autoimmune diabetes can occur with a number of other autoimmune conditions, when it is known as the Autoimmune Polyglandular Syndrome. By far the commonest association is with hypothyroidism which is usually tested for by a TSH test. Many centers now do this test throughout childhood and the teen years.

Rare associations have been recorded for a number of other conditions; but the only two that have been consistently suggested for screening are for celiac disease, now using the easier transglutaminase test which may be positive in up to 10% of new onset cases and anti-21-hydroxylase antibody. The latter has an incidence of nearer 2% and is usually unaccompanied by any symptoms; but it is felt that it is important to be forewarned of the possibility of adrenal insufficiency.

A negative test for celiac disease now does not ensure that your daughter will never get the condition, and the test should be repeated if there are overt symptoms including poor growth and some would also argue where there is chronic poor blood sugar control.

DOB