Login to MyKarger

New to MyKarger? Click here to sign up.



Login with Facebook

Forgot your password?

Authors, Editors, Reviewers

For Manuscript Submission, Check or Review Login please go to Submission Websites List.

Submission Websites List

Institutional Login
(Shibboleth or Open Athens)

For the academic login, please select your country in the dropdown list. You will be redirected to verify your credentials.

Original Paper

Screening for Associated Autoimmunity in Children and Adolescents with Type 1 Diabetes Mellitus (T1DM)

Karavanaki K.a · Kakleas K.a · Paschali E.b · Kefalas N.c · Konstantopoulos I.a · Petrou V.c · Kanariou M.b · Karayianni C.a

Author affiliations

aDiabetic Clinic, B’ Pediatric Department, University of Athens, ‘P. & A. Kyriakou’ Children’s Hospital, bDepartment of Immunology and Histocompatibility, ‘Aghia Sophia’ Children’s Hospital, and cDepartment of Pediatric Endocrinology, ‘P. & A. Kyriakou’ Children’s Hospital, Athens, Greece

Related Articles for ""

Horm Res 2009;71:201–206

Do you have an account?

Login Information





Contact Information










I have read the Karger Terms and Conditions and agree.



Login Information





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
  • Unrestricted printing, no saving restrictions for personal use
read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.


Save over 20% compared to the individual article price.
Learn more

Rent/Cloud

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

Rental: USD 8.50
Cloud: USD 20.00


Select

Subscribe

  • Access to all articles of the subscribed year(s) guaranteed for 5 years
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates


Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: December 17, 2007
Accepted: May 14, 2008
Published online: March 04, 2009
Issue release date: April 2009

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

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

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

Abstract

Background/Aims: Type 1 diabetes (T1DM) is associated with autoimmune thyroid, celiac, autoimmune gastric and Addison’s disease. Our aim was to investigate the prevalence of associated autoantibodies in relation to the demographic and β-cell autoantibody status (anti-GAD). Methods: Antibodies against thyroid peroxidase (anti-TPO), thyroglobulin (anti-Tg), tissue transglutaminase (anti-tTG IgA), parietal cells (APCA) and adrenal tissue (AAA) were measured in 144 children with T1DM with a mean ± SD age of 12.3 ± 4.6 years and a diabetes duration of 4.6 ± 3.8 years. Results: The prevalence of antibody positivity among our patients was: anti-GAD 53.2%, anti-thyroid (anti-TPO 17.4%, anti-Tg 11.1%); anti-tTG IgA 7.6%, APCA 4.0%, and AAA 0%. Among the children with positive anti-thyroid antibodies, 60% developed autoimmune thyroiditis, while among those anti-tTG IgA positive, 62.5% developed biopsy-confirmed celiac disease. Female gender was more frequent among anti-tTG IgA-positive patients (OR 4.47, p = 0.068), while increasing age was associated with anti-Tg positivity (OR 22.9, p = 0.041). The presence of anti-thyroid antibodies was associated with the presence of anti-GAD (OR 1.45, p = 0.01) and parietal cell antibodies (OR 4.98, p = 0.09). Conclusion: Among T1DM patients, the prevalence rates of anti-thyroid and parietal cell antibodies increased with age and diabetes duration. As the presence of anti-GAD was associated with gastric and thyroid autoimmunity, it could serve as marker for the development of additional autoimmunity in adolescents with diabetes.

© 2009 S. Karger AG, Basel


References

  1. Atkinson MA, Maclaren NK: The pathogenesis of insulin-dependent diabetes mellitus. N Engl J Med 1994;331:1428–1436.
  2. Atkinson MA, Eisenbarth GS: Type 1 diabetes: new perspectives on disease pathogenesis and treatment. Lancet 2001;358:221–229.
  3. MacLaren NK, Riley WJ: Thyroid, gastric, and adrenal autoimmunities associated with insulin-dependent diabetes mellitus. Diabetes Care 1985;8(suppl 1):34–38.
    External Resources
  4. Komrower GM: Coeliac disease in a diabetic child. Lancet 1969;i:1215.
    External Resources
  5. Holl RW, Bohm B, Loos U, Grabert M, Heinze E, Homoki J: Thyroid autoimmunity in children and adolescents with type 1 diabetes mellitus: effect of age, gender and HLA type. Horm Res 1999;52:113–118.
  6. Prazny M, Skrha J, Limanova Z, Vanickova Z, Hilgertova J, Prazna J, Jaresova M, Striz I: Screening for associated autoimmunity in type 1 diabetes mellitus with respect to diabetes control. Physiol Res 2005;54:41–48.
  7. 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.
  8. Irvine WJ, Scarth L, Clarke BF, Cullen DR: Thyroid and gastric autoimmunity in patients with diabetes mellitus. Lancet 1970; ii:163–168.
    External Resources
  9. Cronin CC, Shanahan F: Insulin-dependent diabetes mellitus and celiac disease. Lancet 1997;349:1096–1097.
  10. Dieterich W, Laag E, Schopper H, Volta U, Ferguson A, Gillett H: Autoantibodies to tissue transglutaminase as predictors of celiac disease. Gastroenterology 1998;115:1317–1321.
  11. Falorni A, Laureti S, Santeusanio F: Autoantibodies in autoimmune polyendocrine syndrome type II. Endocrinol Metab Clin North Am 2002;31:369–389.
  12. Barker JM, Yu J, Yu L, Wang J, Miao D, Bao F, Hoffenberg E, Nelson JC, Gottlieb PA, Rewers M, Eisenbarth GS: Autoantibody ‘subspecificity’ in type 1 diabetes. Diabetes Care 2005;28:850–855.
  13. Liesenkotter KP, Kiebler A, Stach B, Willgerodt H, Gruters A: Small thyroid volumes and normal iodine excretion in Berlin schoolchildren indicate full normalization of iodine supply. Exp Clin Endocrinol Diabetes 1997;105:46–50.
  14. Hansen D, Bennedbaek FN, Hansen LK, Hoier-Madsen M, Hegedus L, Jacobsen BB, Husby S: High prevalence of coeliac disease in Danish children with type 1 diabetes mellitus. Acta Paediatr 2001;90:1238–1243.
  15. Marcocci C, Vitti P, Cetani F, Catalano F, Concetti R, Pinchera A: Thyroid ultrasonography helps to identify patients with diffuse lymphocytic thyroiditis who are prone to develop hypothyroidism. J Clin Endocrinol Metab 1991;72:209–213.
  16. Barera G, Bonfati R, Viscardi M, Bazzigaluppi E, Calori G, Meschi F, Bianchi C, Chiumello G: Occurrence of coeliac disease after onset of type 1 diabetes: a 6-year prospective longitudinal study. Pediatrics 2002;109:833–838.
  17. Kordonouri O, Klinghammer A, Lang EB, Gruters-Kieslich A, Grabert M, Holl RW: Thyroid autoimmunity in children and adolescents with type 1 diabetes: a multicenter survey. Diabetes Care 2002;25:1346–1350.
  18. Sumnik Z, Cinek O, Bratanic N, Lebl J, Rozsai B, Limbert C, Paskova M, Schober E: Thyroid autoimmunity in children with coexisting type 1 diabetes mellitus and celiac disease: a multicenter study. J Pediatr Endocrinol Metab 2006;19:517–522.
  19. Perros P, McCrimmon RJ, Shaw G, Frier BM: Frequency of thyroid dysfunction in diabetic patients: value of annual screening. Diabet Med 1995;12:622–627.
  20. Bagchi N, Brown TR, Parish RF: Thyroid dysfunction in adults over age 55 years. A study in an urban US community. Arch Intern Med 1990;150:785–787.
  21. 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;32:387–395.
  22. 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.
  23. 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.
  24. Talal N: Autoimmunity and the immunological network. Arthritis Rheum 1978;21:853.
  25. Fraser-Reynolds KA, Butzner JD, Stephure DK, Trussell RA, Scott RB: Use of immunoglobulin A-antiendomysial antibody to screen for celiac disease in North American children with type 1 diabetes. Diabetes Care 1998;21:1985–1989.
  26. Carlsson AK, Axelsson IEM, Borulf SK, Bredberg AC, Lindberg BA, Sjoberg KG, Ivarsson SA: Prevalence of IgA-antiendomysium and IgA-antigliadin autoantibodies at diagnosis of insulin-dependent diabetes mellitus in Swedish children and adolescents. Pediatrics 1999;103:1248–1252.
  27. Lampasona V, Bonfanti R, Bazzigaluppi E, Venerando A, Chiumello G, Bosi E, Bonifacio E: Antibodies to tissue transglutaminase C in type 1 diabetes. Diabetologia 1999;42:1195–1198.
  28. Freemark M, Levitsky LL: Screening for celiac disease in children with type 1 diabetes. Two views of the controversy. Diabetes Care 2003;26:1932–1939.
  29. Ludvigsson JF, Ludvigsson J, Ekbom A, Montgomery SM: Celiac disease and risk of subsequent type 1 diabetes. Diabetes Care 2006;29:2483–2488.
  30. Rensch MJ, Merenich JA, Liebermann M, Long BD, Davis DR, McNally PR: Gluten-sensitive enteropathy in patients with insulin-dependent diabetes mellitus. Ann Intern Med 1996;124:564–567.
  31. Yu L, Brewer KW, Gates S, Wang T, Babu S, Goulieb PA, Freed BM, Noble J, Erlich HA, Eisenbarth GS: DRB1*04 and DQ alleles: expression of 21-hydroxylase autoantibodies and risk of progression to Addison’s disease. J Clin Endocrinol Metab 1999;84:328–335.
  32. Marks SD, Girgis R, Cough RM: Screening for adrenal antibodies in children with type 1 diabetes mellitus and autoimmune thyroid disease. Diabetes Care 2003;26:3187–3188.
  33. Cerutti F, Bruno G, Chiarelli F, Lorini R, Meschi F, Sacchetti C; Diabetes Study Group of the Italian Society of Pediatric Endocrinology and Diabetology: Younger age at onset and sex predict celiac disease in children and adolescents with type 1 diabetes: an Italian multicenter study. Diabetes Care 2004;27:1294–1298.
  34. Tanriverdi F, Silveira LFG, MacColl GS, Bouloux PMG: The hypothalamic-pituitary-gonadal axis: immune function and autoimmunity. J Endocrinol 2003;176:293–304.
  35. Da Silva JAP: Sex hormones, glucocorticoids, and autoimmunity: facts and hypotheses. Ann Rheum Dis 1995;54:6–16.
  36. Fox HS: Androgen treatment prevents diabetes in nonobese diabetic mice. J Exp Med 1992;175:1409–1412.
  37. Ahmed SA, Talal N: Sex hormones and the immune system – Part 2. Animal data. Baillieres Clin Rheumatol 1990;4:13–31.
  38. Gilon P, Tappaz M, Remade C: Localization of GAD-like immuno-reactivity in the pancreas and stomach of the rat and mouse. Histochemistry 1991;96:355–365.
  39. 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.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: December 17, 2007
Accepted: May 14, 2008
Published online: March 04, 2009
Issue release date: April 2009

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

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

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


Copyright / Drug Dosage / Disclaimer

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.
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 government 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.