Premium
Autoimmune characteristics in Japanese children diagnosed with type 1 diabetes before 5 years of age
Author(s) -
Urakami Tatsuhiko,
Suzuki Junichi,
Yoshida Ayako,
Saito Hiroshi,
Wada Mika,
Takahashi Shouri,
Mugishima Hideo
Publication year - 2009
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.2008.02758.x
Subject(s) - medicine , autoantibody , type 1 diabetes , diabetes mellitus , autoimmunity , antibody , pathogenesis , glutamate decarboxylase , autoimmune disease , pediatrics , young adult , immunology , gastroenterology , endocrinology , enzyme , biochemistry , chemistry
Background: Several studies have shown that the autoimmune features in young children with type 1 diabetes differ from those in older pediatric patients as well as adults. The purpose of the present study was to examine the prevalence of β‐cell autoantibodies, glutamic acid decarboxylase antibodies (GADA), and antibodies to the protein tyrosine phosphatase‐related molecule IA‐2 (IA‐2A), at the time of diagnosis in Japanese children with type 1 diabetes who were younger than 5 years at diagnosis. Methods: Subjects consisted of 23 Japanese children (nine boys, 14 girls), 3.1 ± 1.3 years of age at diagnosis (range, 1.1–4.8 years). The majority had severe metabolic decompensation accompanied by complete absence of β‐cell function at diagnosis. We found 41.7% to have suffered viral infections before disease onset. Results: The prevalence of antibodies to GAD and IA‐2 at diagnosis in these subjects was significantly lower than those in older patients diagnosed after 5 years of age (31.6 % vs 86.3% and 47.1% vs 82.5%, P < 0.0001 and P = 0.0064, respectively). Among 17 patients in whom both antibodies were measured, only two (11.8%) had both GADA and IA‐2A, three (17.6%) had GADA alone, six (35.3%) had IA‐2A alone, and six (35.3%) had neither GADA nor IA2‐A. Conclusions: Non‐autoimmune mechanisms or age‐related differences in autoimmunity could be involved in the pathogenesis of diabetes in young patients.