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Clinical heterogeneity among pediatric patients with autoimmune type 1 diabetes stratified by immunoglobulin deficiency
Author(s) -
Hogendorf Anna,
Szymańska Małgorzata,
Krasińska Joanna,
BaranowskaJaźwiecka Anna,
Ancuta Marta,
Charubczyk Anna,
Wyka Krystyna,
Drozdz Izabela,
SokolowskaGadoux Magdalena,
Zarebska Joanna,
Michalak Arkadiusz,
Szadkowska Agnieszka,
JaroszChobot Przemysława,
Młynarski Wojciech
Publication year - 2021
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.13208
Subject(s) - medicine , type 1 diabetes , antibody , immunology , immunoglobulin g , diabetes mellitus , pediatrics , endocrinology
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.