Clinical heterogeneity among pediatric patients with autoimmune type 1 diabetes stratified by immunoglobulin deficiency
| Autor: | Krasińska Joanna, Szadkowska Agnieszka, Młynarski Wojciech, Jarosz‐Chobot Przemysława, Drozdz Izabela, Anna Charubczyk, Wyka Krystyna, Szymańska Małgorzata, Hogendorf Anna, Ancuta Marta, Zarebska Joanna, Arkadiusz Michalak, Baranowska‐Jaźwiecka Anna, Sokolowska Magdalena |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Immunoglobulin E Immunoglobulin D Cohort Studies Hypogammaglobulinemia 03 medical and health sciences 0302 clinical medicine IgE deficiency Internal medicine Prevalence Internal Medicine medicine Humans Medical history 030212 general & internal medicine Age of Onset IgG Deficiency Child IgM deficiency Type 1 diabetes biology business.industry Immunologic Deficiency Syndromes medicine.disease Immunoglobulin A Diabetes Mellitus Type 1 Phenotype Immunoglobulin G Pediatrics Perinatology and Child Health biology.protein Female Poland business Nephelometry |
| Zdroj: | Pediatric Diabetes. 22:707-716 |
| ISSN: | 1399-5448 1399-543X |
| DOI: | 10.1111/pedi.13208 |
| Popis: | Type 1 diabetes (T1D) may coexist with primary immunodeficiencies, indicating a shared genetic background.To evaluate the prevalence and clinical characteristics of immunoglobulin deficiency (IgD) among children with T1D.Serum samples and medical history questionnaires were obtained during routine visits from T1D patients aged 4-18 years. IgG, IgA, IgM, and IgE were measured by nephelometry and enzyme-linked immunosorbent assay (ELISA). IgG and IgM deficiency (IgGD, IgMD) were defined as IgG/IgM2 standard deviations (SD) below age-adjusted mean. IgE deficiency was defined as IgE2 kIU/L. IgA deficiency (IgAD) was defined as IgA2 SD below age-adjusted mean irrespective of other immunoglobulin classes (absolute if0.07 g/L, partial otherwise) and as selective IgAD when IgA2 SD below age-adjusted mean with normal IgG and IgM (absolute if0.07 g/L, partial otherwise).Among 395 patients (53.4% boys) with the median age of 11.2 (8.4-13.7) and diabetes duration 3.6 (1.1-6.0) years, 90 (22.8%) were found to have hypogammaglobulinemia. The IgGD and IgAD were the most common each in 40/395 (10.1%). Complex IgD was found in seven patients. Increased odds of infection-related hospitalization (compared to children without any IgD) was related to having any kind of IgD and IgAD; OR (95%CI) = 2.1 (1.2-3.7) and 3.7 (1.8-7.5), respectively. Furthermore, IgAD was associated with having a first-degree relative with T1D OR (95%CI) = 3.3 (1.4-7.6) and suffering from non-autoimmune comorbidities 3.3 (1.4-7.6), especially neurological disorders 3.5 (1.2-10.5).IgDs frequently coexist with T1D and may be associated with several autoimmune and nonimmune related disorders suggesting their common genetic background. |
| Databáze: | OpenAIRE |
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