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- Title
Clinical relevance and cost-effectiveness of HLA genotyping in children with Type 1 diabetes mellitus in screening for coeliac disease in the Netherlands.
- Authors
Elias, J.; Hoorweg‐Nijman, J. J. G.; Balemans, W. A.
- Abstract
Aims To investigate the clinical relevance and cost-effectiveness of human leukocyte antigen ( HLA)-genotyping in the Netherlands as a screening tool for the development of coeliac disease in children with Type 1 diabetes mellitus. Methods A retrospective analysis was performed in 110 children with Type 1 diabetes mellitus diagnosed between January 1996 and January 2013. All children were screened for coeliac disease using coeliac disease-specific antibodies and HLA genotyping was performed in all children. Results One hundred and ten children were screened for coeliac disease, and coeliac disease could be confirmed in seven. Eighty-six per cent of the children with Type 1 diabetes mellitus had one of the variants of HLA- DQ2.5 and DQ8. HLA genotypes observed in children with Type 1 diabetes mellitus children and coeliac disease were heterozygote DQ2.5, homozygote DQ2.5 and heterozygote DQ2.5/ DQ8. HLA genotyping in coeliac disease screening in children with Type 1 diabetes mellitus is more expensive than screening for coeliac disease with antibodies alone (€326 vs. €182 per child). Conclusions The risk of coeliac disease development in children with Type 1 diabetes mellitus is increased when they are heterozygote DQ2.5/ DQ8, homozygote or heterozygote DQ2.5. The implementation of HLA genotyping as a first-line screening tool has to be reconsidered because it is not distinctive or cost-effective.
- Subjects
NETHERLANDS; CELIAC disease diagnosis; CELIAC disease; CONFIDENCE intervals; COST control; COST effectiveness; FISHER exact test; GENETICS; IMMUNOGLOBULINS; TYPE 1 diabetes; MEDICAL screening; MEDICAL societies; POPULATION; T-test (Statistics); HLA-B27 antigen; DATA analysis; RETROSPECTIVE studies; DESCRIPTIVE statistics; ODDS ratio; GENOTYPES; DISEASE risk factors
- Publication
Diabetic Medicine, 2015, Vol 32, Issue 6, p834
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1111/dme.12658