Journal Mobile Options
Table of Contents
Vol. 77, No. 2, 2012
Issue release date: April 2012
Section title: Original Paper
Horm Res Paediatr 2012;77:121–126
(DOI:10.1159/000336923)

Gastric Autoimmunity in Children and Adolescents with Type 1 Diabetes: A Prospective Study

Kakleas K. · Kostaki M. · Critselis E. · Karayianni C. · Giannaki M. · Anyfantakis K. · Haramaras I. · Fotinou A. · Papathanasiou A. · Karavanaki K.
aDiabetic Clinic, Second University Department of Pediatrics, ‘P. & A. Kyriakou’ Children’s Hospital, National and Kapodistrian University of Athens School of Medicine, bGastroenterology Clinic, Second University Department of Pediatrics, ‘P. & A. Kyriakou’ Children’s Hospital, cDepartment of Pediatric Endocrinology and dHormone Laboratory, ‘P. & A. Kyriakou’ Children’s Hospital, and eMicrobiology Department, ‘Aghia Sophia’ Children’s Hospital, Athens, Greece

Do you have an account?

Register and profit from personalized services (MyKarger) Login Information

Please create your User ID & Password





Contact Information









I have read the Karger Terms and Conditions and agree.

Register and profit from personalized services (MyKarger) Login Information

Please create your User ID & Password





Contact Information









I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger (new!)
  • Unrestricted printing, no saving restrictions for personal use
  • Reduced rates with a PPV account
read more

Direct: USD 38.00
Account: USD 26.50

Select

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restriction apply

Rental: USD 8.50
Cloud: USD 20.00

Select

Subscribe

  • Automatic perpetual access to all articles of the subscribed year(s)
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates


Select


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 7/21/2011
Accepted: 1/30/2012
Published online: 3/15/2012

Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 3

ISSN: 1663-2818 (Print)
eISSN: 1663-2826 (Online)

For additional information: http://www.karger.com/HRP

Abstract

Background/Aims: Type 1 diabetes (T1DM) is associated with gastric autoimmunity, which is characterized by the presence of parietal cell antibodies (APCA). We investigated gastric autoimmunity prevalence in T1DM children, its manifestations, determinants and association with thyroid gland (anti-Tg, anti-TPO) and pancreatic β-cell autoimmunity (anti-GAD) at baseline and 4 years later. Methods: The initial cohort (D1) included 97 children with T1DM. At follow-up after 4 years (D2), 84.5% of participants were evaluated. We assessed APCA, anti-Tg, anti-TPO, and anti-GAD presence, as well as symptoms of gastritis. APCA-positive patients were evaluated with gastrin, B12, ferritin levels and were submitted to gastroscopy. Results: Thyroid antibody positivity was increased among the APCA-positive patients. Four years later, among initially APCA-positive patients, 2/6 became APCA negative, while 4/6 developed high titers of APCA. On gastroscopy, 2 patients had chronic hypertrophic gastritis and one Helicobacter pylori gastritis. Conclusions: Gastric autoimmunity was associated with thyroid autoimmunity and anti-GAD persistence. After 4 years, the majority of APCA-positive patients developed high titers of APCA and mild symptoms of gastritis. Thus, patients with T1DM, and in particular those with thyroid and/or pancreatic autoimmunity, should have periodic autoantibody screening for the early diagnosis and follow-up of gastric autoimmunity.


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 7/21/2011
Accepted: 1/30/2012
Published online: 3/15/2012

Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 3

ISSN: 1663-2818 (Print)
eISSN: 1663-2826 (Online)

For additional information: http://www.karger.com/HRP


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Borg H, Fernlund P, Sundkvist G: Protein tyrosine phosphatase-like protein IA2-antibodies plus glutamic acid decarboxylase 65 antibodies (GADA) indicates autoimmunity as frequently as islet cell antibodies assay in children with recently diagnosed diabetes mellitus. Clin Chem 1997;43:2358–2363.
  2. Landin-Olsson M, Palmer JP, Lernmark Å, Blom L, Sundkvist G, Nyström L, Dahlquist G: Predictive value of islet cell and insulin autoantibodies for type 1 (insulin-dependent) diabetes mellitus in a population-based study of newly-diagnosed diabetic and matched control children. Diabetologia 1992;35:1068–1073.
  3. DeBlock CE, De Leeuw IH, Peleckmans PA, Callens D, Maday E, Van Gaal LF: Delayed gastric emptying and gastric autoimmunity in type 1 diabetes. Diabetes Care 2002;25:912–917.
  4. De Block CE, De Leeuw IH, Vertommen JJ, Rooman RP, Du Caju MV, Van Campenhout CM, Weyler JJ, Winnock F, Van Autreve J, Gorus FK, Belgian Diabetes Registry: Beta-cell, thyroid, gastric, adrenal and coeliac autoimmunity and HLA-DQ types in type 1 diabetes. Clin Exp Immunol 2001;126:236–241.
  5. Frohlich-Reiterer EE, Huber J, Katz H, Suppan E, Obermayer-Pietsch B, Deutschmann A, et al: Do children and adolescents with type 1 diabetes mellitus have a higher frequency of parietal cell antibodies than healthy controls? J Pediatr Gastroenterol Nutr 2011;52:558–562.

    External Resources

  6. De Block CE, De Leeuw IH, Rooman RP, Winnock F, Du Caju MV, Van Gaal LF: Gastric parietal cell antibodies are associated with glutamic acid decarboxylase-65 antibodies and the HLA DQA1*0501-DQB1*0301 haplotype in type 1 diabetes mellitus. Belgian Diabetes Registry. Diabet Med 2000;17:618–622.
  7. De Block CE, De Leeuw IH, Van Gaal LF, and the Belgian Diabetes Registry: High prevalence of manifestations of gastric autoimmunity in parietal cell antibody-positive type 1 diabetic patients. J Clin Endocrinol Metab 1999;84:4062–4067.
  8. Kordonouri O, Klinghammer A, Lang EB, Gruters-Keslich A, Grabert M, Holl RW: Thyroid autoimmunity in children and adolescents with type 1 diabetes. Diabetes Care 2002;24:1346–1350.

    External Resources

  9. Maugender D, Guilhem I, Karacatsanis C, Poirier JY, Leguerrier AM, Lorcy Y, Derrien C, Sonnet E, Massart C: Anti-TPO antibodies and screening of thyroid dysfunction in type 1 diabetic patients. Ann Endocrinol (Paris) 2000;61:524–530.

    External Resources

  10. Kordonouri O, Deiss D, Danne T, Dorow A, Bassir C, Gruters-Kieslich A: Predictivity of thyroid autoantibodies for the development of thyroid disorders in children and adolescents with type 1 diabetes. Diabet Med 2002;19: 518–521.
  11. Alberti KG; Zimmet PZ: Definition, diagnosis and classification of diabetes mellitus and its complications. 1. Diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998;15:539–553.
  12. Karavanaki K, Kakleas K, Paschali E, Kefalas N, Konstantopoulos I, Hadjiathanasiou C, Kanariou M, Karayianni C: Screening for associated autoimmunity in children and adolescents with type 1 diabetes mellitus. Horm Res 2009;71:201–206.
  13. Kakleas K, Paschali E, Kefalas N, Fotinou A, Kanariou M, Karayianni Ch, Karavanaki K: Factors for thyroid autoimmunity in children and adolescents with type 1 diabetes mellitus. Ups J Med Sci 2009;114:214–220.
  14. Landin-Olsson M, Karlsson A, Dahlquist G, Blom L, Lernmark A, Sundkvist G: Islet cell and other organ-specific autoantibodies in all children developing type 1 (insulin dependent) diabetes mellitus in Sweden during one year and in matched control children. Diabetologia 1989;2:387–395.

    External Resources

  15. Jaeger C, Hatziagelaki E, Petzoldt R, Bretzel RG: Comparative analysis of organ-specific autoantibodies and celiac disease-associated antibodies in type 1 diabetic patients, their first-degree relatives, and healthy control subjects. Diabetes Care 2001;24:27–32.
  16. Jacobson DL, Gange SJ, Rose NR, Graham NM: Epidemiology and estimated population burden of selected autoimmune diseases in the United States. Clin Immunol Immunopathol 1997;84:223–243.
  17. Neufeld M, Maclaren N, Blizzard R: Autoimmune polyglandular syndromes. Pediatr Ann 1980;9:154–163.
  18. Barova H, Perusicova J, Hill M, Sterzl I, Vondra K, Masek Z: Anti-GAD-positive patients with type 1 diabetes mellitus have higher prevalence of autoimmune thyroiditis than anti-GAD negative patients with type1 and type 2 diabetes mellitus. Physiol Res 2004;53:279–286.
  19. Talal N: Autoimmunity and the immunological network. Athritis Rheum 1978;21:853.
  20. Decochez K, Tits J, Coolens JL, et al: High frequency of persisting or increasing islet-specific autoantibody levels after diagnosis of type 1 diabetes presenting before 40 years of age. Diabetes Care 2000;23:838–844.
  21. Becker KGRM, Simon JE, Bailey-Wilson B, Freidlin WE, Biddison HF, McFarland JM: Clustering of non-major histocompatibility complex susceptibility candidate loci in human autoimmune diseases. Proc Natl Acad Sci USA 1998;95:9979–9984.
  22. Becker KG: Comparative genetics of type 1 diabetes and autoimmune disease: common loci, common pathways? Diabetes 1999;48:1353–1358.
  23. Silveira PA, Baxter AG, Cain WE, van Driel IR: A major linkage region on distal chromosome 4 confers susceptibility to mouse autoimmune gastritis. J Immunol 1999;162:5106–5111.
  24. Tsai LH, Taniyama K, Tanaka C: Gamma-aminobutyric acid stimulates acid secretion from the isolated guinea pig stomach. Am J Physiol 1987;253:G601–G606.
  25. Ahren B: GABA inhibits thyroid hormone secretion in the mouse. Thyroidology 1989;1:105–108.
  26. Esteban M, Baxter AG: Polyspecificity of autoimmune responses in type 1 (autoimmune) diabetes. Clin Exp Immunol 2001;126:184–186.
  27. De Block CEM, De Leeuw IH, Van Gaal LF: Autoimmune gastritis in type 1 diabetes: a clinically oriented review. J Clin Endocrinol Metab 2008;93:363–371.
  28. Hershko C, Ronson A, Souroujon M, Maschler I, Heyd J, Patz J: Variable hematologic presentation of autoimmune gastritis: age-related progression from iron deficiency to cobalamin depletion. Blood 2006;107:1673–1679.
  29. Muhsen K, Barak M, Henig C, Alpert G, Ornoy A, Cohen D: Is the association between Helicobacter pylori infection and anemia age dependent? Helicobacter 2010;15:467–472.

    External Resources

  30. Gürbüz AK, Küçükkardali Y, Yazgan Y, Ozel M, Polat T: Does eradication of Helicobacter pylori infection reduce hypergastrinema during long term therapy with proton pump inhibitors? Turk J Gastroenterol 2002;13:159–163.
  31. Segni M, Borrelli O, Pucarelli I, Delle Fave G, Pasquino AM, Annibale B: Early manifestations of gastric autoimmunity in patients with juvenile autoimmune thyroid disease. J Clin Endocrinol Metab 2004;89:4944–4948.