Late development of IgA antiendomysial antibodies and small intestinal mucosal atrophy after insulin dependent diabetes mellitus onset

Abstract
Editor,—Recent studies have demonstrated that coeliac disease can develop months or years after the clinical onset of insulin dependent diabetes mellitus (IDDM).1 Over the last 10 years, 200 consecutive children with IDDM at the onset have been tested for IgG and IgA antigliadin antibodies (AGA) by indirect immunofluorescence2 and for IgA antiendomysial antibodies (EmA) using monkey oesophagus and, more recently, human umbilical cord as substrate.3 An antibody follow up was also performed in 151 of these patients every 3–6 months. At initial testing six diabetic children (four girls and two boys, median age 9 years, range 2–13) were positive for both IgA EmA and IgA AGA (associated with IgG …

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