Autoimmune disorders associated with type 1 diabetes mellitus in Saudi children and adolescent
Nasir A. M. Al-Jurayyan
Journal Title:Basic Research Journal of Medicine and Clinical Science
Background: Patients with type 1 diabetes mellitus are at increased risk of developing other autoimmune disease. Objectives: To determine the prevalence of various autoimmune disorders in 305 patients with type 1 diabetics. Design: A retrospective, hospital based-study. Materials and Methods: The associations of other autoimmune disorders in type 1 diabetic were reviewed. Diagnosis of CD was based on positivity of screening serum, and proved by histopathological findings of intestinal biopsy specimen. Thyroid dysfunction was assessed by anti-microsomal peroxilase (TPO) and antithyroglobulin (anti-TG) antibodies coupled with diagnostic thyroid function (TSH and FT4), while for adrenal dysfunction was based on low serum cortisol and high serum ACTH. Results: The cohort includes 305 Saudi children and adolescents, 163 (53.4%) were females and 142 (46.6%) males. Thyroid dysfunction was evident in 65 (21.3%) patients, of those, 26 (8.5%) patients had evidence of overt hypothyroidism. Thirty-nine (12.8%) patients had sub-clinical hypothyroidism. Thyroid microsomal peroxilase (TPO) and thyroglobulin (TG) antibodies were done in the sera of 114 (37.4%) patients. Seventy-six (66.7%) patients were euthyroid, 20 (17.5%) patients with overt-hypothyrodism and 10 (15.8%) patients with sub-clinical hypothyroidism. Interestingly, in 16 (80%) patients with overt hypothyroidism were positive for both TPO and TG antibodies) while the majority of the euthyroid patients (93.2%) both TPO and TG antibodies were negative. Sixty-two (20.3%) patients were referred for endoscopy and biopsy. In 26 (8.5%) patients, the biopsies were abnormal. Only one patient was found to be adrenal insufficient with autoimmune polyendocrinopathy syndrome (APSI). Conclusion: The prevalence of other organ-specific disorders is high in patients with type 1 diabetics. After autoimmune thyroiditis, the second most commonly reported is celiac disease. Although, further follow-up period is needed to determine the natural history of these autoantibodies in patients with type 1 diabetes mellitus. The current strategy for screening should be reviewed.
Keywords: Autoimmune disorders, type 1 diabetes mellitus, Saudi, children, adolescent