Extrapancreatic Autoimmune Manifestations in Type 1 Diabetes Patients and Their First-Degree Relatives

Abstract

OBJECTIVE -To investigate the prevalence of autoimmune diseases in young patients (probands) with type 1 diabetes and their first-degree relatives, and to determine the spectrum of extrapancreatic manifestations in these subjects. RESEARCH DESIGN AND METHODS-The study population included 109 probands age 13 Ϯ 4.9 years and 412 first-degree relatives age 28.7 Ϯ 16.2 years. The prevalence rates of autoimmune thyroiditis and celiac disease were determined in all probands and in 100 of the 412 first-degree relatives. Control groups included 78 subjects age 14.9 Ϯ 10.4 years for the prevalence of autoimmune thyroiditis and 120,000 youth ages 16 -17 years for the prevalence of celiac disease. Thyroiditis and celiac disease were diagnosed by abnormally high thyroid peroxidase (TPO), thyroglobulin (TG), antigliadin, and antiendomysial antibody titers. Celiac was confirmed by biopsy. A questionnaire was used to interview probands and relatives to determine the spectrum of autoimmune manifestations.RESULTS -The prevalence of autoimmune thyroiditis determined by high TPO and/or TG titers was 27 and 25% for probands and relatives, respectively. These rates were higher than those for control subjects (P Ͻ 000.1). The prevalence of celiac disease among probands and screened relatives was 8.3 and 6%, respectively. These rates were higher than those for control subjects and the 312 family members interviewed only (0.1 and 0.3%, respectively; P Ͻ 0.0001). Interviews of participants revealed a wide range of associated autoimmune diseases. The risk of developing an autoimmune disease was higher (P Ͻ 0.001) in families with a proband who had an additional autoimmune manifestation.CONCLUSIONS -Screening for autoimmune thyroiditis and celiac disease should be performed in patients with type 1 diabetes and their first-degree relatives, especially when the probands have an additional autoimmune manifestation.

Seroprevalence of autoimmune thyroiditis and celiac disease in children with insulin-dependent diabetes mellitus in the Thrace region of Turkey

“…A large body of evidence indicates that inherited genetic factors influence both susceptibility and resistance to the disease. There is significant familial clustering of diabetes mellitus, with an average prevalence risk in siblings of 6% compared to 0.4% in the general population (8,10). In our study population, we detected a family history of DM that is higher than is usually reported.…”

“…Its prevalence varies from 8% to 50%, depending on the age, sex and ethnic origin of the subjects. In control populations, antiTPOabs are present in 0-27.0% of patients (8,9,11). It has been reported that follow-up of AIT is important not only for the detection of hypothyroidism, but also for the early diagnosis of papillary carcinoma and thyroid lymphoma.…”

“…Its prevalence varies from 8% to 50% in IDDM patients, depending on the age, sex and ethnic origin of the subject. Thirty-nine percent of AIT diagnoses come within one year of IDDM diagnosis (8,9).…”

Prevalência de disfunção tireoidiana e anticorpos antitireoidianos em pacientes portadores de diabetes melito tipo 1 e em seus familiares de primeiro grau

“…As semelhanças no padrão genético de herança e suscetibilidade, além do mecanismo auto-imune compartilhado entre essas endocrinopatias, associadas ao aumento na incidência delas em todo o mundo, têm estimulado pesquisadores a estudar, epidemiologicamente, não só os portadores destas patologias como seus familiares de primeiro grau (4)(5)(6)(7). Estudos mundiais revelam diferentes valores de prevalência de anticorpos antitireoidianos em pacientes com DM1, que variam de 3% a 50% (8).…”

Organ specific autoimmune disorders in type 1 diabetes mellitus

“…Twenty five percent of firstdegree relatives of patients with T1DM patients have AIT and up to 6% have CD. 6 These diseases usually occurring together in same individual and having shared genet ic predisposition are associated with organ specific autoantibodies. T1DM is associated with Insulin Auto Antibody (IAA), glutamic acid decarboxylase (GAD) antibody and islet cell antigen [ICA]512 (IA2) antibody; AIT with anti thyroid peroxidase (anti TPO) and anti thyroglobulin (anti TG) antibodies; CD with anti tissue trans glutaminase (anti TTG), endomysial autoantibodies (EMA) and AD with anti 21  hydroxylase auto antibodies.…”