Prevalência de outras doenças autoimunes em crianças e adolescentes com diabetes mellitus tipo 1

Abstract

OBJECTIVE: To evaluate the prevalence of autoimmune markers associated with beta-pancreatic cells, autoimmune thyroid diseases and celiac disease through research of anti-glutamic acid decarboxylase antibodies (GADA), antiislet cell antibodies (ICA), anti-insulin antibodies (IAA), anti-tyrosine phosphatase (IA-2A), anti-transglutaminase antibodies (anti-tTG), anti-endomysium anti-transglutaminase antibodies (EMA ), immunoglobulin A (IgA), thyroperoxidase antibodies (anti-TPO) and thyroglobulin antibodies (anti-TG), in addition to related hormonal measurements in children and adolescents with type 1 diabetes mellitus. METHODS: Observational, longitudinal study, with retrospective data collection by reviewing the medical records of 92 children and adolescents, diagnosed with DM1 between January 2014 and December 2016, seen at a Pediatric Endocrinology service of a tertiary hospital in Curitiba- PR. RESULTS: At the diagnosis of DM1, the prevalence of anti-GAD antibody positivity was 69.6% (n = 79), ICA 42.9% (n = 70), IAA 32.8% (n = 64), IA2 of 60.6% (n = 33). Positivity for markers of other associated autoimmune diseases was 27.4%, EMA 6.0% (n = 50), anti t-TG IgA 12.5% (n = 8), anti-TPO 13, 1% (n = 84) and 22.9% anti-TG (n = 83). Autoimmune thyroid diseases were the most frequently found comorbidity at diagnosis (22.1%). Among patients with positivity for antithyroid antibodies, 19% developed clinical hypothyroidism. CONCLUSIONS: Patients with DM1 have a high prevalence of autoimmunity. The importance of screening for such diseases to diagnosis and clinical follow-up is reinforced, in order to assist in predicting the development of associated diseases and their complications, as well as providing adequate treatment.