Autoimmune thyroiditis in children and adolescents with type 1 diabetes.

INTRODUCTION: In children and adolescents with type 1 diabetes coexist some other autoimmune diseases such as autoimmune thyroiditis, celiac disease, Addison's disease or others. AIM OF THE STUDY: was to assess the incidence and risk factors for autoimmune thyroiditis in children and adolescents with type 1 diabetes at the moment of diagnosis.
MATERIAL AND METHODS: The study included 382 children, who in the years 2001 to 2010 were diagnosed with type 1 diabetes. The concentrations of antibodies against thyroid peroxidase (anti- TPO), TSH and FT4 were measured and thyroid ultrasound examinations were performed. Children who had not initially shown the presence of anti-TPO had the test repeated at yearly intervals for 2-8 years.
RESULTS: At the time of diagnosis of diabetes, elevated anti-TPO titres were found in 14.4% of patients, more often in girls than in boys, p<0.01. Children with a positive anti-TPO titre were on average older than those whose anti-TPO levels were within the normal range, p<0.05. The incidence of elevated titers of anti-TPO increased with age, 20,5% of children above 10 years old had positive anti-TPO, compared to 8.3% of children less than 10 years old, p <0.001. At the time of the onset of diabetes, hypothyroidism was diagnosed in 14.5% of children with elevated anti-TPO, and in 2.1% of the whole group. 4.5% of patients whose levels of anti-TPO were initially normal, within the next 1-8 years had positive antibody titers.
CONCLUSIONS: Due to the high incidence of the disease, it is necessary to carry out screenings for autoimmune thyroiditis in children with diabetes at the time of diagnosis and redo them in accordance with the recommendations.