Associated Autoimmune Disease in Children with Recent Onset Type 1 Diabetes in a Córdoba Population

Presentation Number: LB SUN 79
Date of Presentation: April 2nd, 2017

Liliana Silvano*1, Adriana Rebeca Boyanovsky1, Silvia Edith Martin2, Maria Paula Paz Povedano3, Maria Paula Rodriguez3, Laura Castro2, Gabriela Sobrero4, Liliana Muñoz4 and Mirta Beatriz Miras4
1Hospital de Niños de la Santísima Trinidad. Córdoba, Córdoba, Argentina, 2Hospital de Niños de la Santísima Trinidad. Córdoba, Argentina, 3Hospital de Niños de Cordoba, Cordoba, Argentina, 4Hospital de Niños de la Santisima Trinidad, Cordoba, Argentina

Abstract

The Type 1 Diabetes (T1DM) is one of the most common chronic diseases in childhood and the incidence is increasing, especially in children less than five years of age. In individuals with genetic predisposition an unidentified trigger initiates an abnormal immune response and the development of beta-cell auto antibodies.There is wide variation in the prevalence of pancreatic and other major autoantibodies in different populations of children with T1DM. The ADA recommended the screening for islet autoantibodies in high-risk individuals.The aimof this study was to describe the frequency of specific beta-cell, thyroid and celiac auto antibodies at the clinical presentation and to analyze the presence of antibodies through the evolution in a Caucasian population of children with T1DM from Córdoba, Argentina between 2011 and 2015.

Patients and methods: we studied 130 children presenting to the Children’ Hospital with criteria for the diagnosis of Diabetes Mellitus between 2011 and 2015. We determined anti-GAD65, anti-IA2, anti-Insulin (AI) antibodies (IRMA- Beckman Coulter), anti-TPO and anti-Tg antibodies (Elecsys-Roche), anti-tTGA antibody (Elisa-Orgentec) and TSH and free T4 (Elecsys-Roche).

Results:The date of patients were: mean CA: 10 years (1.1-14.7), mean BMI: 17.2 (11.2-25.7), mean height: 0.64 SDS. Anti-GAD65, anti-IA2 and anti-AI antibodies were positive in 73 %, 60%, 39% respectively. The 51 % of the patients presented Anti-GAD65 and anti-IA2 positives and the 12% were negatives. Thyroid autoimmunity was present in 18 % of cases. The 7.6% of the patients were hypothyroid to debut moment. All of them were without treatment for the thyroid condition in this stage. New cases didn’t detect during the follow up. The frequency of thyroid autoimmuty increased 6.5% during follow up. Anti-tTGA antibody was positive in 13.6% of patients and not shown modification in the follow up of T1DM.

Conclusions: The analized patients exhibited similar prevalence of beta-cell autoimmunity compared with other Caucasian populations. Our dates, based on the prevalence of autoimmune disease markers associated with T1DM, contributes to emphasize the importance of making these determinations regularly and to develop consensus that include the respective diagnostic strategies with the aim of reducing the morbidity and mortality associated with T1DM.

 

Nothing to Disclose: LS, ARB, SEM, MPP, MPR, LC, GS, LM, MBM