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Vol. 61. Issue 4.
Pages 320-325 (1 October 2004)
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Vol. 61. Issue 4.
Pages 320-325 (1 October 2004)
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Autoinmunidad pancreática, tiroidea y relacionada con la celiaquía en niños con diabetes mellitus tipo 1
Beta-Cell, thyroid and coeliac autoimmunity in children with type 1 diabetes
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J.A. López Medinaa,
Corresponding author
jalopezmedina@eresmas.com

Correspondencia: Avda. de la Constitución, 22, 4.°H. 18012. Granada. España
, R. López-Jurado Romero de la Cruzb, A. Delgado Garcíac, R. Espigares Martína, J.L. Barrionuevo Porrasa, L. Ortega Martosa
a Servicios de Pediatría. Hospital Universitario Virgen de las Nieves. Granada. España
b Servicios de Ginecología y Obstetricia. Hospital Universitario Virgen de las Nieves. Granada. España
c Servicios de Medicina Nuclear. Hospital Universitario Virgen de las Nieves. Granada. España
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Objetivo

El objetivo de este estudio ha sido investigar en niños que presentan diabetes mellitus tipo 1 (DM1) la presencia de autoinmunidad pancreática, tiroidea y relacionada con la celiaquía

Métodos

Se incluyeron todos los niños que presentaron DM1. Se analizaron datos de 63 niños con un rango de edad de 2 a 14 años, que fueron tratados en el centro maternoinfantil del hospital universitario Virgen de las Nieves de Granada durante el período 1998-2002. Se midieron y registraron los anticuerpos antiglutamato descarboxilasa (GADA), antiinsulina (AAI), antiperoxidasa tiroidea (anti-TPO), antitiroglobulina (anti-TG), inmunoglobulinas estimulantes del tiroides (TSI) y anticuerpos antiendomisio (AAE-IgA) relacionados con la enfermedad celíaca. El 55,5% de los pacientes eran de sexo femenino, la edad media fue de 7,9 ± 3,2 años

Resultados

El porcentaje de positividad para los distintos anticuerpos fue: GADA, 65,1 %; AAI, 68,3 %; anti-TPO, 11,1 %; anti-TG, 9,5 %; TSI, 4,8% y AAE-IgA, 3,1 %. Los niños con autoinmunidad tiroidea presente eran en el momento del diagnóstico de su diabetes de mayor edad y desarrollaban su enfermedad más tarde que los niños sin autoinmunidad tiroidea. Los pacientes anti-TPO positivos presentaban niveles más elevados de hormona tirostimulante, mayor prevalencia de bocio y disfunción tiroidea que los niños sin anti-TPO

Conclusiones

Los niños que presentan DM1 presentan una alta prevalencia de autoinmunidad tiroidea y relacionada con la enfermedad celíaca. En caso de presentar estos marcadores positivos es preciso prestar especial atención a la posible asociación de otras enfermedades, completando los estudios que se precisen. Estas medidas pueden prevenir complicaciones y mejorar la evolución de la enfermedad diabética

Palabras clave:
Diabetes tipo 1
Anticuerpos específicos de órgano
Autoinmunidad tiroidea
Enfermedad celíaca
Objective

The aim of this study was to evaluate the presence of beta-cell, thyroid and coeliac autoimmunity in children with recent-onset type 1 diabetes

Methods

We studied all children with newly diagnosed type 1 diabetes. Data were analyzed from 63 children aged 2-14 years who were treated in the Department of Pediatrics of the Virgen de las Nieves University Hospital in Granada (Spain) from 1998-2002. Antibodies to glutamic acid decarboxylase- 65 (GADA), anti-insulin (AIA), thyroperoxidase (anti-TPO), thyroglobulin (anti-TG), thyroid-stimulating immunoglobulins (TSI) and endomysial antibodies (EmA-IgA) were measured and documented. A total of 55.5% of these patients were girls and the mean age was 7.9 ± 3.2 years

Results

The prevalence rates were: GADA 65.1 %; AIA 68.3%; anti-TPO 11.1 %; anti-TG 9.5 %; TSI 4.8 % and EmA-Ig A 3.1%. Children with thyroid antibodies (anti-TPO+) were significantly older and developed diabetes later in life (P < 0.05) than those without antibodies. Thyroid-stimulating hormone levels, goiter and thyroid dysfunction were higher in children who were anti-TPO+ than in diabetic children without thyroid autoimmunity

Conclusions

Children with newly diagnosed type 1 diabetes show a high prevalence of thyroid and coeliac autoimmunity. In cases of positivity, additional work-up and intervention are advocated. These measures can prevent the well-known complications of diabetes and improve its clinical course

Key words:
Type 1 diabetes
Organ-specific antibodies
Thyroid autoimmunity
Celiac disease
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Copyright © 2004. Asociación Española de Pediatría
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