Using different screening procedures for auto antibodies, the reported prevalence of CD in patients with T1DM ranged from 0.6–16.4%.[6] Among different types of serological tests for screening CD, such as anti-gliadin antibodies (AGAs) and antiendomysial IgA antibody (EMA), tissue transglutaminase antibodies (tTGA) has proved to be a very specific indicator to identify subjects with latent CD.[7] It is well known that clinical CD represents only the tip of the iceberg. Here, NAGS is linked to Cowden disease.