Autoimmune hepatitis related autoantibodies in children with type 1 diabetes

Al–Hussaini, Abdulrahman; AlZahrani, Musa D; Alenizi, Ahmed; Suliman, Nimer M; Khan, Mannan; Alharbi, Sahar; Chentoufi, Aziz Alami

doi:10.1186/1758-5996-6-38

Cited by 13 publications

(9 citation statements)

References 20 publications

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“…Its presence has been persistently related with AIH-2. It is probable that, at least in the pediatric ages, DM1 is also present in AIH-1, as it has been recently reported but poorly investigated [5,12]. On the other hand, there is also a relationship among patients with DM1 with celiac disease and AIH-1 [9], and its existence is probably not rare in a greater number of individuals with these associations.…”

Section: Discussionmentioning

confidence: 85%

“…This suggests that autoimmunity to tissue-specific autoantigens may involve other organs, expressing proteins that share similarity to the initial autoantigen by means of a cross mechanism and may lead to the clinical manifestation as an autoimmune disease in individuals susceptible for ANA and SMA characteristic of AIH-1. This particularity has been limitedly studied in adults and in children [12,13]. Its presence has been persistently related with AIH-2.…”

Section: Discussionmentioning

confidence: 99%

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Immunological disorders: (Type 1 Diabetes, Idiopathic Thrombocytopenic Purpura and Hashimoto Encephalopathy), Associated with Autoimmune Hepatitis

Sotelo-Cruz¹,

López-Cervantes²,

Campbell-Araujo³

2015

Immunome Res

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Autoimmune hepatitis (AIH) is a liver disease that runs a course of chronic and progressive inflammation. This occurs in young children and adolescents. AIH can also be manifested in an acute and aggressive form. Its etiology is unknown. Two varieties have been reported. These are autoimmune hepatitis type 1 (AIH-1) and type 2 (AIH-2). AIH-1 affects children as well as adults and it is related with the presence of antinuclear (ANA) and anti-smooth muscle (ASM) antibodies. AIH-1 is associated with immunological illnesses such as ulcerative colitis, sclerosing cholangitis, arthritis, and vasculitis. AIH-2 is more frequent in children. It presents with liver and kidney microsome (Anti-LKM-1) antibodies and anti-cytosol antibodies (Anti-LC-1). AIH-2 has also been associated with other immunopathies such as polyendocrinopathy, vitiligo, thyroiditis, alopecia and diabetes mellitus type 1 (DM1). This report describes the clinical course of two patients with AIH: a female treated since five years of age and followed during 18 years. After 11 years, the patient developed DM1 and later anorexia nervosa. This patient died due to complications of the latter. The other patient, who was diagnosed with AIH at the age of 10 years, was treated and followed during 10 years. This patient manifested idiopathic thrombocytopenia purpura (IPT) and Hashimoto encephalopathy during the course of the disease. This patient continues to remain under control. The relationship of AIH-1 with other autoimmune processes, such as Diabetes mellitus type 1 (DM1) until now, has been poorly investigated. Also, ITP followed by Hashimoto encephalopathy was a rare association in our patient. It has been considered that these are a consequence of autoimmune dysregulation.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Immunological disorders: (Type 1 Diabetes, Idiopathic Thrombocytopenic Purpura and Hashimoto Encephalopathy), Associated with Autoimmune Hepatitis

Sotelo-Cruz¹,

López-Cervantes²,

Campbell-Araujo³

2015

Immunome Res

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“…The prevalence of AIH in patients with T2DM seems to be similar to the prevalence in the general population possibly pointing towards the fact that these two diseases are not associated. Up to now, however, a possible relationship between T1DM and AIH has been poorly investigated, mainly restricted to immunological aspects [1,[25][26][27][28].…”

Section: Discussionmentioning

confidence: 99%

“…The pathogenesis of type 1 diabetes mellitus (T1DM) is characterized by autoimmune destruction of beta cells in the pancreas [1]. Being an autoimmune disorder, T1DM is associated with other immune-mediated diseases, such as autoimmune thyroid disease (AIT) [2], celiac disease [3,4], and Addison's disease [5], suggesting a common genetic susceptibility [6].…”

Section: Introductionmentioning

confidence: 99%

“…Demographical, clinical, and metabolic comparison of patients with T2DM with or without AIH.Except for age, sex and diabetes duration, values are adjusted means ± SEM. Adjustments were made for age, sex and diabetes duration; T2DM: Type 2 diabetes mellitus; AIH: Autoimmune hepatitis; BMI: Body-mass-index; OAD: Oral antidiabetic drugs;1 For patients with insulin therapy.Further funding has been received from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 115797 (INNODIA) supported by the European Union's Horizon 2020 research and innovation program and "EFPIA", 'JDRF" and "The Leona M. and Harry B. Helmsley Charitable Trust". The German Diabetes Association (DDG), the European Foundation for the Study of Diabetes (EFSD), and the German Robert Koch Institute (RKI) provided additional financial support.…”

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confidence: 99%

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Diabetes Mellitus and Autoimmune Hepatitis: Demographical and Clinical Description of a Relatively Rare Phenotype

et al. 2018

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We studied demographic, metabolic, and clinical characteristics of patients with diabetes and autoimmune hepatitis (AIH) from the German/Austrian DPV registry. A total of 139 patients with diabetes and AIH were analyzed and compared to 437 728 patients with diabetes without AIH. The prevalence of AIH in patients with T1DM (44.8/100 000) seems higher than in the general population, the prevalence of AIH in patients with T2DM (23.6/100 000) does not seem to be increased. Patients with T2DM and AIH had a shorter duration of diabetes (p=0.007) and a higher proportion of females (p<0.001) compared to T2DM without AIH. Patients with diabetes (T1DM or T2DM) and AIH required higher insulin doses (p<0.001 and p=0.03, respectively) and showed increased liver enzymes (aspartate transaminase, alanine transaminase, gamma-glutamyltransferase) compared to diabetes patients without (all p<0.001). We detected a lower percentage of patients treated with oral antidiabetic drugs (p=0.01) and a higher percentage of patients treated by insulin in patients with T2DM and AIH (p<0.001) compared to patients with T2DM alone. We observed a higher incidence of autoimmune thyroid disease (AIT) in patients with diabetes (T1DM or T2DM) and AIH (p<0.001) compared to diabetes patients without AIH. AIH seems more frequent in patients with T1DM. Patients with diabetes and AIH require intensification of antidiabetic therapy and seem to have a higher prevalence of AIT.

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