Open Access Highly Accessed Research article

Incomplete gastric metaplasia in children with insulin-dependent diabetes mellitus and celiac disease. An ultrastructural study

Marina Bertini1, Andrea Sbarbati2*, Enrico Valletta1, Leonardo Pinelli1 and Luciano Tatò1

Author Affiliations

1 Department of Pediatrics, University of Verona, Verona, Italy

2 Institute of Anatomy and Histology, University of Verona, Verona, Italy

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BMC Clinical Pathology 2001, 1:2  doi:10.1186/1472-6890-1-2

Published: 25 June 2001

Abstract

Background

The association of insulin-dependent diabetes mellitus (IDDM) and celiac disease (CD) has been widely reported in children but the relationship between the two conditions is incompletely understood. Moreover, specific studies on intestinal biopsies of patients with the association of the two diseases are still lacking.

Methods

We studied the ultrastructure of the duodenal mucosa in 12 patients with both IDDM and CD.

Results

All patients had either total or partial atrophy of duodenal mucosa. In seven subjects, an accumulation of electrondense granules in the apical cytoplasm of groups of enterocytes was found. In four of them, a double population of granules existed (mean diameter: 400-800 nm and 100-200 nm respectively) showing a biphasic pattern. In the other three patients, only smaller granules (100- 200 nm) were found in the enterocytes.

Conclusions

The present work suggests that patients with IDDM/CD may represent a subgroup in the context of the CD population. Intestinal biopsies of such individuals often show accumulation of electrondense granules in the apical cytoplasm of enterocytes that can be interpreted as incomplete gastric metaplasia.