Title: Celiac disease autoimmunity among Nigerian children and adolescents with type 1
diabetes mellitus
Version: 5 Date: 02 Sep 2024
Reviewer's report:
Dear Authors,
Thank you very much for re-submitting your work, and giving me the opportunity to review
the revised manuscript.
There were some important issues in the initial manuscript that were addressed by the authors.
Majority of comments were included in the revised manuscript, and some were explained in
more detail in Authors response.
I do still have some comments that should be addressed further.
The decision to perform IgA EMA in IgA deficient patients is a limitation of the study. Despite
some reports in the literature, that patients with negative IgA TGA, were later found to be
positive for IgA EMA, majority of IgA deficient patients will not be able to produce IgA EMA,
so it would be appropriate in these patients to perform either of the IgG tests: EMA, TGA or
DGP. By performing IgA EMA in IgA deficient patients there is a higher risk of false negative
results.
Please make sure to provide the information that total IgA in children varies with age and that
reference ranges of lower limit of normality for total IgA are lower for smaller children than
for older ones.
Please check again for the use of CD and celiac autoimmunity.
Refrain from using the term CD if patients were not diagnosed according to currently available
guidelines (high Ab titers and double serology or positive titer and appropriate histopathology)
»Prevalence of celiac disease in children with T1DM«
»The study found that the prevalence of seropositive CD among Nigerian children and
adolescents«
In this respect it is also suggested to include the term Celiac disease autoimmunity in the title
of the manuscript.
Instead of using the term “celiac antibodies” it would be appropriate to use either “celiac disease
specific antibodies” or perhaps “markers of celiac autoimmunity”
Title: Celiac disease autoimmunity among Nigerian children and adolescents with type 1
diabetes mellitus
Version: 5 Date: 02 Sep 2024
Reviewer's report:
Dear Authors,
Thank you very much for re-submitting your work, and giving me the opportunity to review
the revised manuscript.
There were some important issues in the initial manuscript that were addressed by the authors.
Majority of comments were included in the revised manuscript, and some were explained in
more detail in Authors response.
I do still have some comments that should be addressed further.
The decision to perform IgA EMA in IgA deficient patients is a limitation of the study. Despite
some reports in the literature, that patients with negative IgA TGA, were later found to be
positive for IgA EMA, majority of IgA deficient patients will not be able to produce IgA EMA,
so it would be appropriate in these patients to perform either of the IgG tests: EMA, TGA or
DGP. By performing IgA EMA in IgA deficient patients there is a higher risk of false negative
results.
Please make sure to provide the information that total IgA in children varies with age and that
reference ranges of lower limit of normality for total IgA are lower for smaller children than
for older ones.
Please check again for the use of CD and celiac autoimmunity.
Refrain from using the term CD if patients were not diagnosed according to currently available
guidelines (high Ab titers and double serology or positive titer and appropriate histopathology)
»Prevalence of celiac disease in children with T1DM«
»The study found that the prevalence of seropositive CD among Nigerian children and
adolescents«
In this respect it is also suggested to include the term Celiac disease autoimmunity in the title
of the manuscript.
Instead of using the term “celiac antibodies” it would be appropriate to use either “celiac disease
specific antibodies” or perhaps “markers of celiac autoimmunity”
Please review this paper.
user
Title: Celiac disease autoimmunity among Nigerian children and adolescents with type 1
diabetes mellitus
Version: 5 Date: 02 Sep 2024
Reviewer's report:
Dear Authors,
Thank you very much for re-submitting your work, and giving me the opportunity to review
the revised manuscript.
There were some important issues in the initial manuscript that were addressed by the authors.
Majority of comments were included in the revised manuscript, and some were explained in
more detail in Authors response.
I do still have some comments that should be addressed further.
The decision to perform IgA EMA in IgA deficient patients is a limitation of the study. Despite
some reports in the literature, that patients with negative IgA TGA, were later found to be
positive for IgA EMA, majority of IgA deficient patients will not be able to produce IgA EMA,
so it would be appropriate in these patients to perform either of the IgG tests: EMA, TGA or
DGP. By performing IgA EMA in IgA deficient patients there is a higher risk of false negative
results.
Please make sure to provide the information that total IgA in children varies with age and that
reference ranges of lower limit of normality for total IgA are lower for smaller children than
for older ones.
Please check again for the use of CD and celiac autoimmunity.
Refrain from using the term CD if patients were not diagnosed according to currently available
guidelines (high Ab titers and double serology or positive titer and appropriate histopathology)
»Prevalence of celiac disease in children with T1DM«
»The study found that the prevalence of seropositive CD among Nigerian children and
adolescents«
In this respect it is also suggested to include the term Celiac disease autoimmunity in the title
of the manuscript.
Instead of using the term “celiac antibodies” it would be appropriate to use either “celiac disease
specific antibodies” or perhaps “markers of celiac autoimmunity”
assistant