Thyroid Autoimmunity and Gluten-Sensitive Enteropathy in Children with Type 1 Diabetes Mellitus

Introduction: To determine the seroprevalence of autoimmune thyroiditis and gluten-sensitive enteropathy (GSE) in patients with type 1 diabetes mellitus (T1DM) and to emphasize the importance of early diagnosis. Patients and Methods: Fifty-five children and adolescents (age ranged 3-18 years) with T1DM were included in the study. Hemoglobin A1c (HbA1c), free T3 (fT3), free T4 (fT4), thyroid stimulating hormone (TSH), anti-tiroglobulin (anti-TG), anti-thyroid peroxidase (anti-TPO), anti-gliadin IgA and IgG, and anti-endomisyum IgA antibody (anti-EMA) were investigated. Results: Eight of our cases (14.5%) were positive for anti-TPO, 9/55 (16.3%) for anti-TG, 8/55 (14.5%) for anti-EMA, 8/55 (14.5%) for anti-gliadin IgA, and 5/55 (9.0%) for anti-gliadin IgG. None of these antibodies were detected in healthy controls. In eight patients, who had positive anti-TPO and anti-TG, thyroid ultrasound results confirmed thyroiditis. Anti-EMA and anti-gliadin IgA were positive in five patients. Four of them were diagnosed with GSE. Conclusion: In patients with T1DM, the seroprevalences of autoimmune thyroiditis and GSE were higher than that in healthy controls. Therefore, regardless of the symptoms of patients, autoimmune thyroiditis and GSE should be investigated in all patients with T1DM. Thus, the most rapid and meaningful method is to investigate the presence of autoantibodies using serological tests.