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- Title
Clinical heterogeneity among pediatric patients with autoimmune type 1 diabetes stratified by immunoglobulin deficiency.
- Authors
Hogendorf, Anna; Szymańska, Małgorzata; Krasińska, Joanna; Baranowska‐Jaźwiecka, Anna; Ancuta, Marta; Charubczyk, Anna; Wyka, Krystyna; Drozdz, Izabela; Sokolowska‐Gadoux, Magdalena; Zarebska, Joanna; Michalak, Arkadiusz; Szadkowska, Agnieszka; Jarosz‐Chobot, Przemysława; Młynarski, Wojciech
- Abstract
Background: Type 1 diabetes (T1D) may coexist with primary immunodeficiencies, indicating a shared genetic background. Objective: To evaluate the prevalence and clinical characteristics of immunoglobulin deficiency (IgD) among children with T1D. Methods: 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/IgM >2 standard deviations (SD) below age‐adjusted mean. IgE deficiency was defined as IgE <2 kIU/L. IgA deficiency (IgAD) was defined as IgA >2 SD below age‐adjusted mean irrespective of other immunoglobulin classes (absolute if <0.07 g/L, partial otherwise) and as selective IgAD when IgA >2 SD below age‐adjusted mean with normal IgG and IgM (absolute if <0.07 g/L, partial otherwise). Results: 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). Conclusions: IgDs frequently coexist with T1D and may be associated with several autoimmune and nonimmune related disorders suggesting their common genetic background.
- Subjects
IMMUNOGLOBULINS; CONFIDENCE intervals; PHOTOMETRY; TYPE 1 diabetes; IMMUNOLOGICAL deficiency syndromes; DISEASE prevalence; QUESTIONNAIRES; ENZYME-linked immunosorbent assay; DESCRIPTIVE statistics; AGAMMAGLOBULINEMIA; ODDS ratio; COMORBIDITY; SYMPTOMS; CHILDREN
- Publication
Pediatric Diabetes, 2021, Vol 22, Issue 5, p707
- ISSN
1399-543X
- Publication type
Article
- DOI
10.1111/pedi.13208