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Latent autoimmune diabetes mellitus in children (LADC) with autoimmune thyroiditis and Celiac disease.
J Pediatr Endocrinol Metab 2004; 17(11):1565-9JP

Abstract

Latent autoimmune diabetes mellitus in adults (LADA) is characterized by clinical presentation as type 2 diabetes mellitus after 25 years of age, initial control achieved with oral hypoglycemic agents for at least 6 months, presence of autoantibodies and some immunogenetic features of type 1 diabetes mellitus. An 8.3 year-old girl was referred to our pediatric endocrinology department because of incidental glucosuria. She did not complain of polyuria, polydipsia, or weight loss. Her body mass index (BMI) was at the 80th percentile. Fasting glucose was 126 mg/dl, and OGTT glucose level at 120 min was 307 mg/dl. Although C-peptide levels were normal, her first phase insulin response (FIR) was lower than the 1st percentile. Anti-insulin antibody (AIA), islet cell antibody (ICA), and anti-glutamic acid decarboxylase (antiGAD) were negative. According to the clinical and laboratory findings, she was diagnosed as having type 2 diabetes mellitus. She was started with oral anti-diabetic treatment for a period of 1 year. Insulin had to be initiated for worsening of HbA1c levels. In the fourth year of follow-up, she was admitted to our hospital with diabetic ketoacidosis although she was on an intensive insulin regimen. At this time, C-peptide levels were low, antiGAD and AIA were positive with HLA DR3/DQ2 haplotype. In addition, her thyroid peroxidase antibody and endomysium antibody were found to be high at follow-up. Small intestinal biopsy revealed celiac disease. This patient may represent the first case of latent autoimmune diabetes mellitus in children (LADC) with autoimmune thyroiditis and celiac disease.

Authors+Show Affiliations

Department of Pediatric Endocrinology, Ankara University School of Medicine, Ankara, Turkey. zehraaycan67@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

15570995

Citation

Aycan, Zehra, et al. "Latent Autoimmune Diabetes Mellitus in Children (LADC) With Autoimmune Thyroiditis and Celiac Disease." Journal of Pediatric Endocrinology & Metabolism : JPEM, vol. 17, no. 11, 2004, pp. 1565-9.
Aycan Z, Berberoglu M, Adiyaman P, et al. Latent autoimmune diabetes mellitus in children (LADC) with autoimmune thyroiditis and Celiac disease. J Pediatr Endocrinol Metab. 2004;17(11):1565-9.
Aycan, Z., Berberoglu, M., Adiyaman, P., Ergür, A. T., Ensari, A., Evliyaoglu, O., ... Ocal, G. (2004). Latent autoimmune diabetes mellitus in children (LADC) with autoimmune thyroiditis and Celiac disease. Journal of Pediatric Endocrinology & Metabolism : JPEM, 17(11), pp. 1565-9.
Aycan Z, et al. Latent Autoimmune Diabetes Mellitus in Children (LADC) With Autoimmune Thyroiditis and Celiac Disease. J Pediatr Endocrinol Metab. 2004;17(11):1565-9. PubMed PMID: 15570995.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Latent autoimmune diabetes mellitus in children (LADC) with autoimmune thyroiditis and Celiac disease. AU - Aycan,Zehra, AU - Berberoglu,Merih, AU - Adiyaman,Pelin, AU - Ergür,Ayça Törel, AU - Ensari,Arzu, AU - Evliyaoglu,Olcay, AU - Siklar,Zeynep, AU - Ocal,Gönül, PY - 2004/12/2/pubmed PY - 2005/2/16/medline PY - 2004/12/2/entrez SP - 1565 EP - 9 JF - Journal of pediatric endocrinology & metabolism : JPEM JO - J. Pediatr. Endocrinol. Metab. VL - 17 IS - 11 N2 - Latent autoimmune diabetes mellitus in adults (LADA) is characterized by clinical presentation as type 2 diabetes mellitus after 25 years of age, initial control achieved with oral hypoglycemic agents for at least 6 months, presence of autoantibodies and some immunogenetic features of type 1 diabetes mellitus. An 8.3 year-old girl was referred to our pediatric endocrinology department because of incidental glucosuria. She did not complain of polyuria, polydipsia, or weight loss. Her body mass index (BMI) was at the 80th percentile. Fasting glucose was 126 mg/dl, and OGTT glucose level at 120 min was 307 mg/dl. Although C-peptide levels were normal, her first phase insulin response (FIR) was lower than the 1st percentile. Anti-insulin antibody (AIA), islet cell antibody (ICA), and anti-glutamic acid decarboxylase (antiGAD) were negative. According to the clinical and laboratory findings, she was diagnosed as having type 2 diabetes mellitus. She was started with oral anti-diabetic treatment for a period of 1 year. Insulin had to be initiated for worsening of HbA1c levels. In the fourth year of follow-up, she was admitted to our hospital with diabetic ketoacidosis although she was on an intensive insulin regimen. At this time, C-peptide levels were low, antiGAD and AIA were positive with HLA DR3/DQ2 haplotype. In addition, her thyroid peroxidase antibody and endomysium antibody were found to be high at follow-up. Small intestinal biopsy revealed celiac disease. This patient may represent the first case of latent autoimmune diabetes mellitus in children (LADC) with autoimmune thyroiditis and celiac disease. SN - 0334-018X UR - https://www.unboundmedicine.com/medline/citation/15570995/Latent_autoimmune_diabetes_mellitus_in_children__LADC__with_autoimmune_thyroiditis_and_Celiac_disease_ L2 - https://www.degruyter.com/doi/10.1515/jpem.2004.17.11.1565 DB - PRIME DP - Unbound Medicine ER -