Thyroid and islet autoantibodies predict autoimmune thyroid disease already at Type 1 diabetes diagnosis

Type 1 diabetes mellitus (T1D), autoimmune thyroid disease, and autoimmune gastritis often occur together forming the so-called autoimmune polyendocrine syndrome type 3 (APS3). We here report a clinical case of a 74-year-old woman who presented for the first time with severe hyperglycemia and ketoacidosis diagnosed as T1D. Further clinical investigations revealed concomitant severe hypothyroidism with autoimmune thyroid disease and severe cobalamin deficiency due to chronic atrophic gastritis. The diagnosis of type 1 diabetes mellitus was confirmed by the detection of autoantibodies against glutamic acid decarboxylase 65, islet cell antibodies, and anti-insulin autoantibodies. Anti-thyroperoxidase, anti-thyroglobulin, and anti-gastric parietal cell antibodies were also clearly positive. The case emphasized that new onset diabetic ketoacidosis, hypothyroidism, and cobalamin deficiency may simultaneously occur, and one disease can mask the features of the other, thereby making diagnosis difficult. It is noteworthy that an APS3 acute episode occurred in an asymptomatic elder woman for any autoimmune diseases.

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Screening for Adrenal Antibodies in Children With Type 1 Diabetes and Autoimmune Thyroid Disease

Diabetes Care ◽

10.2337/diacare.26.11.3187 ◽

2003 ◽

Vol 26 (11) ◽

pp. 3187-3188 ◽

Cited By ~ 13

Author(s):

S. D. Marks ◽

R. Girgis ◽

R. M. Couch

Keyword(s):

Type 1 Diabetes ◽

Thyroid Disease ◽

Autoimmune Thyroid Disease ◽

Autoimmune Thyroid

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Autoimmune Thyroid Disease Correlates to Islet Autoimmunity on Zinc Transporter 8 Autoantibody: A Cross-Section Study

10.21203/rs.3.rs-60065/v1 ◽

2020 ◽

Author(s):

Yun Cai ◽

Jieni Yan ◽

Yong Gu ◽

Heng Chen ◽

Qingfang Hu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Thyroid Disease ◽

Autoimmune Thyroid Disease ◽

Islet Autoantibodies ◽

Islet Autoimmunity ◽

Thyroid Autoantibodies ◽

Healthy Controls ◽

Autoimmune Thyroid ◽

Relative Value

Abstract Background The most common coexisting organ-specific autoimmune disease in patients with Type 1 diabetes mellitus (T1DM) is autoimmune thyroid disease (AITD). Many studies have showed prevalence rate of thyroid autoantibodies range from 3.7-35% in T1DM patients, while some of them suggested the associations between thyroid autoantibodies and islet autoantibodies. However, little work has been done about the anti-islet autoimmune status in patients with autoimmune thyroid disease (AITD), and so far there have been no clinical report based on large population about zinc transporter 8 autoantibody (ZnT8A) in patients with AITD. We aimed to explore the presence of islet autoantibodies, ZnT8A, glutamic acid decarboxylase autoantibodies (GADA) and tyrosine phosphatase autoantibodies (IA-2A) compared with thyroid autoantibodies, thyroid peroxidase autoantibodies (TPOAb) and thyroglobulin autoantibodies (TGAb) and thyrotropin receptor autoantibodies (TRAb) in AITD patients. Methods In total 740 AITD patients, 108 type 1 diabetes mellitus (T1DM) patients with AITD, 172 non-autoimmune thyroid disease (nAITD) patients and 115 healthy controls were recruited in the cross-sectional study. Islet autoantibodies, ZnT8A, GADA, IA-2A and thyroid autoantibodies, TPOAb, TGAb, TRAb were detected with Radioimmunoassay and Chemiluminescence. Islet autoantibody relative value was established to compare the distribution of the three islet autoantibodies. Results The prevalence of ZnT8A and GADA in AITD group was significantly higher than that in healthy controls (ZnT8A: 15.00% vs 1.74%, GADA: 7.97% vs 0.87%, both P<0.05). Similarly, the prevalence of IA-2A in AITD group was higher than that in healthy controls (4.19% vs 0%, P<0.05). However, any islet autoantibodies positive rate in AITD group was significantly lower than that in T1DM with AITD group. Analysis of multivariable linear regression suggested that ZnT8A relative value was positively related with GADA relative value (β=0.352, P<0.01) and TPOAb titer (β=0.002, P<0.01), and GADA relative value was also positively related with ZnT8A relative value (β=0.183, P<0.01). Conclusions An increased prevalence of ZnT8A as well as a relatively high prevalence of islet autoimmunity was found in AITD patients, indicating that there is a potential link between thyroid autoimmunity and islet autoimmunity. Trial registration Retrospectively registered.

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Autoimmune thyroid disease and type 1 diabetes mellitus: same pathogenesis; new perspective?

Therapeutic Advances in Endocrinology and Metabolism ◽

10.1177/2042018820958329 ◽

2020 ◽

Vol 11 ◽

pp. 204201882095832

Author(s):

Liyan Li ◽

Shudong Liu ◽

Junxia Yu

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Autoimmune Diseases ◽

Type 1 Diabetes Mellitus ◽

Thyroid Disease ◽

Autoimmune Thyroid Disease ◽

Current Knowledge ◽

Tyrosine Phosphatase ◽

Autoimmune Thyroid

Autoimmune thyroid disease (AITD) and type 1 diabetes mellitus (T1DM) are two common autoimmune diseases that can occur concomitantly. In general, patients with diabetes have a high risk of AITD. It has been proposed that a complex genetic basis together with multiple nongenetic factors make a variable contribution to the pathogenesis of T1DM and AITD. In this paper, we summarize current knowledge in the field regarding potential pathogenic factors of T1DM and AITD, including human leukocyte antigen, autoimmune regulator, lymphoid protein tyrosine phosphatase, forkhead box protein P3, cytotoxic T lymphocyte-associated antigen, infection, vitamin D deficiency, and chemokine (C-X-C motif) ligand. These findings offer an insight into future immunotherapy for autoimmune diseases.

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