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Immunoglobulin deficiency and respective clinical manifestations in pediatric patients with type 1 Diabetes Mellitus
| Summary: | Objective: To evaluate the prevalence of immunoglobulin deficiency among pediatric patients with type 1 diabetes followed in São João Hospital and University Center, and analyze the clinical characteristics of these patients, namely the occurrence of infections and the presence of comorbidities. Material and Methods: A retrospective cohort study was performed including patients aged 4 to 18, with an established diagnosis of type 1 diabetes. The measurement of immunoglobulin levels, glycated hemoglobin, IgA anti-tissue transglutaminase and antithyroid antibodies were obtained in routine appointments. The caregivers were asked to answer a questionnaire about the children's medical history, which was complemented with medical records. IgA, IgM and IgG deficiency were considered when the value of the respective immunoglobulin was below the normal age-adjusted reference range, and IgE deficiency when IgE <2 kU/L, regardless of the value of other classes of immunoglobulins. Selective IgA, IgE, IgM or IgG deficiency was defined when a single class of immunoglobulin deficiency was present. Results: Of the 40 patients enrolled, 22 (55.0%) were males, the median age was 13.0 years old, with a median type 1 diabetes duration of 6.0 years. A total of 6 (15%) patients were found to have immunoglobulin deficiency, 7.5% for IgA (n=3), 5.0% for IgE (n=2), and 2.5% for IgM (n=1). No association between selective IgA, selective IgE, or any type of immunoglobulin deficiency was found with age, type 1 diabetes duration or age at type 1 diabetes onset, glycated hemoglobin, first-degree relative with immunodeficiency or type 1 diabetes, other comorbidities, number of infections per year, infection-related hospitalization, previous history of infection (either of the skin, central nervous system, respiratory, gastrointestinal or urinary), or abnormally elevated values of IgA anti-tissue transglutaminase or antithyroglobulin antibody. Antithyroid peroxidase antibody >5.6 UI/ml was associated with IgE deficiency (p=0.046). Conclusions: Immunoglobulin deficiency is frequent among pediatric patients with type 1 diabetes, suggesting a common background. Immunoglobulin deficit did not seem to be related to a higher risk of infection or comorbidities. Selective IgE deficiency may be associated with the presence of antithyroid peroxidase antibodies. |
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| Subject: | Medicina clínica Clinical medicine |
| Country: | Portugal |
| Document type: | master thesis |
| Access type: | Restricted |
| Associated institution: | Repositório Aberto da Universidade do Porto |
| Language: | English |
| Origin: | Repositório Aberto da Universidade do Porto |
| Summary: | Objective: To evaluate the prevalence of immunoglobulin deficiency among pediatric patients with type 1 diabetes followed in São João Hospital and University Center, and analyze the clinical characteristics of these patients, namely the occurrence of infections and the presence of comorbidities. Material and Methods: A retrospective cohort study was performed including patients aged 4 to 18, with an established diagnosis of type 1 diabetes. The measurement of immunoglobulin levels, glycated hemoglobin, IgA anti-tissue transglutaminase and antithyroid antibodies were obtained in routine appointments. The caregivers were asked to answer a questionnaire about the children's medical history, which was complemented with medical records. IgA, IgM and IgG deficiency were considered when the value of the respective immunoglobulin was below the normal age-adjusted reference range, and IgE deficiency when IgE <2 kU/L, regardless of the value of other classes of immunoglobulins. Selective IgA, IgE, IgM or IgG deficiency was defined when a single class of immunoglobulin deficiency was present. Results: Of the 40 patients enrolled, 22 (55.0%) were males, the median age was 13.0 years old, with a median type 1 diabetes duration of 6.0 years. A total of 6 (15%) patients were found to have immunoglobulin deficiency, 7.5% for IgA (n=3), 5.0% for IgE (n=2), and 2.5% for IgM (n=1). No association between selective IgA, selective IgE, or any type of immunoglobulin deficiency was found with age, type 1 diabetes duration or age at type 1 diabetes onset, glycated hemoglobin, first-degree relative with immunodeficiency or type 1 diabetes, other comorbidities, number of infections per year, infection-related hospitalization, previous history of infection (either of the skin, central nervous system, respiratory, gastrointestinal or urinary), or abnormally elevated values of IgA anti-tissue transglutaminase or antithyroglobulin antibody. Antithyroid peroxidase antibody >5.6 UI/ml was associated with IgE deficiency (p=0.046). Conclusions: Immunoglobulin deficiency is frequent among pediatric patients with type 1 diabetes, suggesting a common background. Immunoglobulin deficit did not seem to be related to a higher risk of infection or comorbidities. Selective IgE deficiency may be associated with the presence of antithyroid peroxidase antibodies. |
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