Celiac Disease and Autoimmune Thyroid Disease in Children with Type 1 Diabetes Mellitus: Clinical and HLA-Genotyping Results
Ayça Törel Ergür1, Gönül Öçal2, Merih Berberoğlu2, Pelin Adıyaman2, Zeynep Şıklar2, Zehra Aycan3, Olcay Evliyaoğlu4, Aydan Kansu5, Nurten Girgin5, Arzu Ensari61Department Of Pediatric Endocrinology, Faculty Of Medicine, Ufuk University, Ankara, Turkey2Department Of Pediatric Endocrinology, Faculty Of Medicine, Ankara University, Ankara, Turkey
3Specialist Dr, Department Of Pediatric Endocrinology, Sami Ulus Hospital, Ankara, Turkey
4Department Of Pediatric Endocrinology, Cerrahpaşa Faculty Of Medicine, Istanbul University, Turkey
5Department Of Pediatric Gastroenterology, Faculty Of Medicine, Ankara University, Ankara, Turkey
6Department Of Pathology, Faculty Of Medicine, Ankara University, Ankara, Turkey
Objective: Increased prevalence of celiac disease (CD) and autoimmune thyroid disorders (ATD) in patients with Type 1 diabetes mellitus (T1D) has been widely reported. Such an association may lead to adverse effects on the growth, bone metabolism and fertility, and response to therapy may become difficult. The aim of this study was to evaluate the clinical findings and HLA typing results in patients with T1D associated with CD or ATD.
Methods: The association of CD and ATD was evaluated in 38 children with T1D aged 1.5-16.8 years who had been followed for 48.3±28 months. Diagnosis of CD was based on positivity for serum endomysial IgA antibody and histopathological findings of intestinal biopsy specimens. Thyroid autoimmunity was assessed by antithyroglobulin and antithyroid peroxidase antibodies and with diagnostic ultrasonographic findings.
Results: ATD was detected in 31.5%, and CD-in 7.8% of T1D patients. Subjects with CD showed either no symptoms or suggestive problems such as short stature, hepatosteatosis, pubertal delay and difficulties in the control of diabetes. Patients with ATD had no clinical symptoms. DQ8 was the most prominent finding in CD.
Conclusions: It is essential that patients with T1D, regardless of presence or absence of symptoms, should be investigated for CD and ATD.
Manuscript Language: English
