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Query: UMLS:C0011854 (
type 1 diabetes
)
20,749
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The results of study on thyroid autoimmunity and its clinical importance gained during 11-year follow-up of 47 adults with
type 1 diabetes
mellitus (DM1) are presented. The study proved the preponderance of women among subject affected with thyroid autoimmunity, the autoantibodies against thyroid gland (T-Ab) were significantly more often detected in women compared to men (68% vs. 32%, p < 0.05). Also, serious forms of thyroid autoimmunity manifested with persistence of both T-Ab, faster development of subclinical
hypothyroidism
(TSH > 4.5 mIU/l in 100% within 4 years after first detection of T-Ab positivity, and within 8 years after DM1 manifestation, respectively), and diffuse hypoechogenic pattern at thyroid gland ultrasonography (USG) were significantly more often observed in women compared to men (45% vs. 12%, p < 0.01). These patients often had small thyroid gland (77% of subjects had volume below 25th percentile of control subjects at the 11th year of follow-up) and presence of thyreopathy in the first degree relatives. No difference between men and women was observed in persistence of thyroid peroxidase autoantibodies (anti-TPO) solely (20% vs. 23%); milder clinical course of thyroid disease was observed in these subjects (the fist detection of TSH > 4.5 mIU/l in the 9th year of follow-up). These patients had varied findings at USG examination with focally/diffuse hypoechogenic/ non-homogenous thyroid gland, and 50% of subjects had thyroid gland volume above 95th percentile in the 11th year of follow-up. Among subjects without thyroid autoimmunity men prevailed (68% vs. 32% women, p < 0.01), and in the 11th year of follow-up the USG finding was often abnormal (thyroid gland volume above 95th percentile of the controls in more than 60% of subjects, trend towards nodulisation). Except for 1 subject, TSH did not exceed 4.5 mIU/l. These results obtained from the Czech population constitute the basis for our recommendation to screen regularly markers of thyroid autoimmunity in patients with DM1. Ultrasonographic examination, that is able to detect sings of thyroid immunopathy in many subjects before first manifestation of T-Ab, is the most sensitive according to both our experience and the published data. For clinical practice, determination of TSH once a year in all DM1 subjects, and of anti-TPO in DM1 women in fertile age is recommended. Ultrasonographic examination should be carried out in case of pathologic results of these tests.
...
PMID:[Thyroid autoimmunity in adults with diabetes mellitus type 1. Own experience gained by 11-year monitoring]. 1706 95
We report about a 41-year old male patient who presented to the emergency room with acute chest pain, exertion dyspnoea, muscle stiffness, myalgia and adynamia. There was no history of coronary artery disease but known arterial hypertension and
insulin dependent diabetes mellitus
. Four weeks before submission the patient had been thyroidectomized after he had been diagnosed with papillary thyroid carcinoma and was now awaiting further radioiodine therapy. The thyroid-stimulating hormone level was markedly elevated to 67 mU/l (normal range 0.27-4.20 mU/l) and fT4 significantly reduced to 0.19 ng/ml (normal range 0.9-1.9 ng/ml). CK was elevated to 328 U/l, cardiac Troponin I (Stratus CS) above the threshold with 0.13 microg/l and Elecsys third generation troponin T above the threshold with 0.04 microg/l. The electrocardiogram showed a normal sinus rhythm and did not reveal any signs of ST-elevation or -depression. During follow-up a cardiac MRI was performed, showing normal dimensions and function but a very small area of diffuse myocardial damage, atypical of ischemic injury. In coronary angiography normal coronary arteries were found. We conclude that cardiac troponins I and T may be elevated in severe
hypothyroidism
without coronary artery disease due to diffuse myocardial injury which can be imaged by MRI.
...
PMID:Positive cardiac troponin I and T and chest pain in a patient with iatrogenic hypothyroidism and no coronary artery disease. 1708 20
The research was undertaken to study the prevalence of TSH receptor antibody positivity in patients with
type 1 diabetes
. A total of 74 subjects with
type 1 diabetes
were enrolled in this cross-sectional study. Thyroid function test and assessment of thyroid autoimmunity with anti-TPO and TSH receptor antibody were done in all patients. A total of 33 males and 41 females with
type 1 diabetes
were studied. The prevalence of TSH receptor antibody positivity alone was 18%. The prevalence of thyroid autoimmunity with anti-TPO as a marker was 28%; the prevalence increased to 43% when TSH receptor antibody was also measured. Majority of the subjects with antithyroid antibody positivity were also positive for GAD65 antibodies. As a significant proportion of type 1 diabetic subjects have positivity to TSH receptor antibody, we suggest that larger studies should be conducted to study the benefits of TSH receptor antibody-based screening for thyroid dysfunction in type 1 diabetic subjects. As the TSH receptor antibodies could be of the stimulating or of the blocking type, subjects with antibody positivity could be at risk of developing hyperthyroidism or
hypothyroidism
.
...
PMID:TSH receptor antibodies in subjects with type 1 diabetes mellitus. 1713 May 58
We report a patient with combined polycystic ovary syndrome (PCOS) and autoimmune polyglandular syndrome (APS) type 2. A 26-year-old female presented with polyuria, polydipsia and acute weight loss. She was diagnosed with: (1)
type 1 diabetes
, with hyperglycemia, impaired insulin secretion, and positive autoantibodies for GAD-65 and IA-2; (2) autoimmune thyroiditis, with
hypothyroidism
, positive anti-microsomal and antithyroglobulin antibodies; and (3) PCOS, with hyperandrogenic signs that had developed 5 years earlier, amenorrhea for the previous 6 months, and characteristic multiple microcystic appearance of both ovaries on ultrasonography. She is being treated with multiple subcutaneous insulin injections, thyroxine replacement, and cyclic medroxyprogesterone for the aforementioned diseases, respectively. Although several investigations have reported a relationship between PCOS and the individual components of APS, this is the first report of both syndromes occurring simultaneously. Potential mechanisms for their interrelation and the possibility that PCOS is an autoimmune disease are discussed.
...
PMID:A patient with combined polycystic ovary syndrome and autoimmune polyglandular syndrome type 2. 1755 82
Breed differences in susceptibility to diabetes mellitus in dogs suggest an underlying genetic component to the pathogenesis of the disease. There is little evidence for an equivalent of human type 2 diabetes in dogs, and it has been proposed that canine diabetes is more comparable to the type 1 form of the disease. Certain immune response genes, particularly those encoding major histocompatibility complex molecules involved in antigen presentation, are important in determining susceptibility to human
type 1 diabetes
. We tested the hypothesis that canine major histocompatibility complex genes (known as the dog leucocyte antigen) are associated with diabetes in dogs. A total of 530 diabetic dogs and more than 1000 controls were typed for dog leucocyte antigen, and associations were found with three specific haplotypes. The DLA-DRB1*009/DQA1*001/DQB1*008 haplotype shows the strongest association with diabetes in the UK dog population. This haplotype is common in diabetes-prone breeds (Samoyed, cairn terrier and Tibetan terrier) but rare in diabetes-resistant breeds (boxer, German shepherd dog and golden retriever), which could explain differences in the prevalence of diabetes in these different breeds. There is evidence that the DLA-DQA1*001 allele is also associated with
hypothyroidism
, suggesting that this could represent a common susceptibility allele for canine immune-mediated endocrinopathies.
...
PMID:Canine diabetes mellitus: from phenotype to genotype. 1761 63
Celiac disease (CD) or gluten sensitive enteropathy is relatively common in western populations with prevalence around 1%. With the recent availability of sensitive and specific serological testing, many patients who are either asymptomatic or have subtle symptoms can be shown to have CD. Patients with CD have modest increases in risks of malignancy and mortality compared to controls. The mortality among CD patients who comply poorly with a gluten-free diet is greater than in compliant patients. The pattern of presentation of CD has altered over the past three decades. Many cases are now detected in adulthood during investigation of problems as diverse as anemia, osteoporosis, autoimmune disorders, unexplained neurological syndromes, infertility and chronic hypertransaminasemia of uncertain cause. Among autoimmune disorders, increased prevalence of CD has been found in patients with autoimmune thyroid disease,
type 1 diabetes
mellitus, autoimmune liver diseases and inflammatory bowel disease. Prevalence of CD was noted to be 1% to 19% in patients with
type 1 diabetes
mellitus, 2% to 5% in autoimmune thyroid disorders and 3% to 7% in primary biliary cirrhosis in prospective studies. Conversely, there is also an increased prevalence of immune based disorders among patients with CD. The pathogenesis of co-existent autoimmune thyroid disease and CD is not known, but these conditions share similar HLA haplotypes and are associated with the gene encoding cytotoxic T-lymphocyte-associated antigen-4. Screening high risk patients for CD, such as those with autoimmune diseases, is a reasonable strategy given the increased prevalence. Treatment of CD with a gluten-free diet should reduce the recognized complications of this disease and provide benefits in both general health and perhaps life expectancy. It also improves glycemic control in patients with
type 1 diabetes
mellitus and enhances the absorption of medications for associated
hypothyroidism
and osteoporosis. It probably does not change the natural history of associated autoimmune disorders.
...
PMID:Celiac disease and autoimmune thyroid disease. 1805 28
Patients with an autoimmune condition are known to be at higher risk of developing other autoimmune disorders. Type 1 diabetes may be associated with additional autoimmune disorders including autoimmune thyroid disease. The aim of this study was to investigate the prevalence of thyroid autoantibodies in a group of children, adolescents, and young adults with
type 1 diabetes
from northeastern Brazil as well as their significance for the development of thyroid disorders. The study design was cross-sectional and descriptive, analyzing young people with a previous
type 1 diabetes
diagnosis. Two hundred and fourteen children and adolescents with prior diagnosis of
type 1 diabetes
were evaluated. Antibodies to thyroperoxidase (anti-TPO) were determined in all patients and thyroid-stimulating hormone (TSH) levels. The anti-TPO antibody test was positive in 54 out of the 214 patients studied, resulting in an overall prevalence of 25.2%. Among the anti-TPO-positive subjects, females were predominant (72%) over males (28%) (p < 0.001). A total of 55.5% patients with positive anti-TPO antibodies had abnormal TSH levels. Clinically significant
hypothyroidism
was found in 29.6% and subclinical
hypothyroidism
in 22.2% of patients with positive anti-TPO. Hyperthyroidism was present in only 3% of them. Our results demonstrate the high prevalence of autoimmune thyroiditis in patients with
type 1 diabetes
and the need for these patients of regular screening to make a precocious diagnosis of thyroid dysfunction.
...
PMID:Prevalence of autoimmune thyroid disease and thyroid dysfunction in young Brazilian patients with type 1 diabetes. 1846 14
A case of a 32-year-old woman with
type 1 diabetes
diagnosed 1.5 year before presention. The patient was referred to the diabetology department due to decompensation of diabetes and excessive hypodermic atrophy of both thighs. Early symptoms of lipoatrophy appeared after 1.5-2 months of insulin glargine use, in spite of frequently changed hypodermic needles and injection sites on both thighs. Simultaneously, deterioration of diabetes compensation was observed (hyperglycaemia between meals and in the morning), which was corrected by the patient with extra injections of a short acting analogue. Additional examinations confirmed
type 1 diabetes
(C-peptide <0.01 ng/ml) with concomitant
hypothyroidism
in the course oh Hashimoto disease. After change of insulin (Insulatard twice daily, Novo Rapid with meals) and injection site (administration to hypodermic tissues of arms and abdomen was started), diabetes compensation was achieved. At follow-up visit after 12 months, diabetes was still under control - HbA1c 6.8%. Moreover, progress of lipoatrophy is not observed.
...
PMID:[Lipoatrophy after use of long acting insulin glargine analogue in a 32-year-old patient with type 1 diabetes]. 1857 50
Patients with autoimmune
type 1 diabetes
mellitus have often, besides immune diabetic markers, also other organ-specific antibodies. In many diabetic patients autoimmune thyroid diseases, i.e. Hashimoto thyroiditis and Grave's disease, with silent clinical course can be diagnosed. Because 50% of children with diabetes and significant titres of thyroid autoantibodies (ATA) develop thyroid problems within 3-4 years, examinations of thyroid antibodies should be performed yearly. In cases of significant antibody titres, thyroid function tests and ultrasound assessment are recommended in order to minimize the risk of undiagnosed
hypothyroidism
in these patients. Coeliac is an other disease commonly coexisting with
type 1 diabetes
mellitus and autoimmune thyroid diseases. It is recommended that screening for coeliac disease should be part of the routine investigation for all patients. Potential benefits of treatment coeliac disease is more prevalent in individuals with
type 1 diabetes
mellitus, and when untreated is associated with a number of medical complications, including poor glycaemic control. Identification of patients with coeliac has been facilitated in recent years by serological screening. Initial normal screening does not exclude coeliac and repeated screening is indicated, a positive IgA antibody test to tTG is a more sensitive parameter than EmA for silent coeliac disease in patients with diabetes. Confirmatory small bowel biopsy, however, remains necessary for diagnosis as some patients with positive antibodies may be without histological changes.
...
PMID:[Coexistance of autoimmunological diseases with type 1 diabetes mellitus in young patients based on literature and own experience]. 1862 23
The occurrence of other autoimmune diseases in celiac disease families has not been previously reported in a North American population. We investigated the familial aggregation of rheumatoid arthritis (RA), juvenile rheumatoid arthritis/juvenile idiopathic arthritis (JRA/JIA),
hypothyroidism
,
insulin dependent diabetes mellitus
(
IDDM
), and alopecia areata (AA) among individuals in families with celiac disease (CD). Family history information, obtained from questionnaires from the University of California Irvine Celiac Disease study, was reviewed for reports of RA, JRA/JIA,
hypothyroidism
,
IDDM
, and AA in celiac disease cases and their first-degree relatives. Reports of disease were compared with prevalence data from the literature and analyzed by calculating the standardized ratio (SR) with 95% confidence limits. We analyzed: (1) subjects with confirmed celiac disease or dermatitis herpetiformis (205 probands and 203 affected first-degree relatives) and (2) first-degree relatives of celiac disease cases (n=1272). We found a significantly increased number of cases, relative to the expected number, of
IDDM
in both groups and
hypothyroidism
among subjects with celiac disease. JRA/JIA was increased among first-degree relatives of celiacs. These results indicate that the presence of
IDDM
within our celiac disease families may be due to shared genetic susceptibility predisposing to these diseases or autoimmune diseases in general.
...
PMID:Co-occurrence of celiac disease and other autoimmune diseases in celiacs and their first-degree relatives. 1869 62
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