Tip 1 Diabetes Mellitus Tanılı Çocuklarda Otoimmün Poliendokrinopati Tip 3b Sıklığı

Year 2020, , 79 - 83, 30.08.2020

İhsan Esen , Uğur Deveci , Deniz Ökdemir

https://doi.org/10.25048/tudod.659818

Cited By: 1

Abstract

Amaç: Tip 3 otoimmün poliendokrinopati sendromu (OPS), Addison hastalığı olmaksızın otoimmün tiroid hastalığı ile diğer bir otoimmün hastalık birlikteliği olarak tanımlanmaktadır. Hastada otoimmün bir gastrointestinal hastalık olursa klinik tablo tip 3b OPS olarak tanımlanır. Bu incelemede çocukluk çağında tip 1 diyabet (T1D) tanısı almış hastalarda tip 3b OPS sıklığı araştırılması amaçlandı.

Gereç ve Yöntemler: Çalışmaya 01.06.2013-31.08.2019 tarihleri arasında takibi yapılmış 232’si erkek 446 T1D’li çocuk çalışmaya alındı. Hashimoto tiroiditi (HT), pozitif anti TPO ve/veya anti-Tg pozitifliği ile otoimmün enteropati ise anti-doku transglutaminaz Ig A pozitifliğini takiben yapılmış ince bağırsak biyopsisinde çölyak hastalığı (ÇH) ile uyumlu histoloji varlığı ile tanımlandı.

Bulgular: Hastaların 61’inde (%13,7) HT ve 34’ünde (%7,6) ÇH tespit edildi. Hastaların 87’sinde (%19,5) HT veya ÇH varken, aynı hastada hem HT hem de ÇH varlığı (tip 3b OPS) sadece 3’ü kız 4 hastada (%0,9) tespit edildi. Tip 3b OPS’li hastaların T1D tanı yaşı sadece HT veya sadece ÇH olanlar ve her iki hastalığı olmayanlar ile karşılaştırıldığında daha düşük olmakla birlikte istatistiksel bir farksaptanmadı (p=0,087).

Sonuç: Çocukluk çağında tanı almış T1D’li çocukların yaklaşık beşte birinde HT veya ÇH tespit edilirken tip 3b OPS sıklığının oldukça nadir olduğu tespit edilmiştir.

Keywords

Çölyak hastalığı, Otoimmün tiroidit, Tip 1 diyabet, Tip 3b Otoimmün Poliendokrinopati Sendromu

Supporting Institution

Yok

Project Number

Yok

The Frequency of Autoimmune Polyendocrinopathy Type 3b in Children with Type 1 Diabetes Mellitus

Abstract

Aim: Autoimmune polyendocrinopathy syndrome type 3 (APS3) is defined as the presence of autoimmune thyroid disease along with another autoimmune disorder other than Addison’s disease. If an autoimmune gastrointestinal disease is a component of the syndrome, it is defined as APS3b. In this study, we aimed to determine the frequency of APS3b in patients diagnosed with type 1 diabetes (T1D) in childhood.

Material and Methods: A patient group of 446 children (232 males) with T1D whose follow-ups were conducted between 01.06.2013 and 31.08.2019 was included in the study. Hashimoto’s thyroiditis (HT) was defined with positive anti-TPO and/or anti-Tg test results whereas autoimmune enteropathy was defined with histologic findings which consisted with celiac disease (CD) in small bowel biopsy following a positive anti tissue transglutaminase IgA.

Results: In total, 61 (13.7%) patients had HT and 34 (7.6%) patients had CD. While 87 (19.5%) of the patients had HT or CD, the occurrence of both HT and CD (APS3b) in the same patient was observed in only 4 patients (3 females) (0.9%). Patients with APS3b had low median age of diagnosis compared with patients with HT or CD alone, and patients with none of these two diseases, but the difference is not statistically significant (p=0.087).

Conclusion: While HT or CD has been detected in approximately one-fifth of children with T1D, APS3b is rarely observed in this patient group.

Keywords

Celiac disease, Autoimmune polyendocrinopathy type 3b, Autoimmune thyroid disease,, Type 1 diabetes

Project Number

Yok

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