[Diabetes mellitus type I, thyroid gland autoimmunity, thyroid gland function and HLA status]

Area of Science:

• Endocrinology
• Immunology
• Pediatrics

Context:

• Type 1 diabetes (T1D) is an autoimmune disease.
• Co-occurrence of autoimmune conditions is common in T1D patients.
• Thyroid autoimmunity is frequently observed in individuals with T1D.

Purpose:

• To investigate the prevalence of cytoplasmatic islet cell antibodies (ICA) and thyroid microsomal antibodies (TMA) in children and adolescents with T1D.
• To assess the association between these antibodies, thyroid function, thyroid enlargement, and HLA-DR3 antigen.
• To evaluate the risk of developing hypothyroidism in T1D patients with thyroid autoimmunity.

Summary:

• A cross-sectional study analyzed sera from 130 children and adolescents with T1D for ICA and TMA, alongside thyroid function tests and examination for thyroid enlargement.
• TMA were detected in 15.4% and ICA in 38.5%. Thyroid enlargement was present in 70% of TMA-positive patients, with one case of biopsy-proven Hashimoto's thyroiditis leading to hypothyroidism.
• No significant association was found between ICA and TMA, or between thyroid autoimmunity and HLA-DR3, despite 40% of TMA-positive patients expressing HLA-DR3.

Impact:

• Highlights the increased risk of thyroid dysfunction, particularly hypothyroidism, in type 1 diabetic patients with thyroid autoimmunity.
• Suggests that screening for thyroid microsomal antibodies is advisable for type 1 diabetics, especially those with thyroid enlargement.
• Informs clinical practice regarding the monitoring and management of autoimmune comorbidities in pediatric type 1 diabetes.