Open AccessSequential elevation of autoantibodies to thyroglobulin and glutamic acid decarboxylase in type 1 diabetes
Author(s) -
Eiji Kawasaki,
Junichi Yasui,
Masako Tsurumaru,
Haruko Takashima,
Toshiyuki Ikeoka,
Fumihiko Mori,
Satoru Akazawa,
Ikuko Ueki,
Masakazu Kobayashi,
Hironaga Kuwahara,
Norio Abiru,
Hironori Yamasaki,
Atsushi Kawakami
Publication year - 2013
Publication title -
world journal of diabetes
Language(s) - English
Resource type - Journals
ISSN - 1948-9358
DOI - 10.4239/wjd.v4.i5.227
Subject(s) - medicine , autoantibody , thyroglobulin , thyroid peroxidase , type 1 diabetes , endocrinology , thyroid function , anti thyroid autoantibodies , diabetes mellitus , autoimmunity , diabetic ketoacidosis , type 2 diabetes , thyroid , disease , immunology , antibody
We have previously reported the high levels of glutamic acid decarboxylase 65 autoantibodies (GAD65A) in patients with type 1 diabetes and autoimmune thyroid disease. Here we describe a 32-year-old Japanese female with a thirteen-year history of type 1 diabetes whose levels of GAD65A were elevated just after the emergence of anti-thyroid autoimmunity. At 19 years of age, she developed diabetic ketoacidosis and was diagnosed with type 1 diabetes. She had GAD65A, insulinoma-associated antigen-2 autoantibodies (IA-2A), and zinc transporter-8 autoantibodies (ZnT8A), but was negative for antibodies to thyroid peroxidase (TPOAb) and thyroglobulin (TGAb) at disease onset. ZnT8A and IA-2A turned negative 2-3 years after the onset, whereas GAD65A were persistently positive at lower level (approximately 40 U/mL). However, just after the emergence of TGAb at disease duration of 12.5 years, GAD65A levels were reelevated up to 5717 U/mL in the absence of ZnT8A and IA-2A. Her thyroid function was normal and TPOAb were consistently negative. She has a HLA-DRB1*03:01/*04:01-DQB1*02:01/*03:02 genotype. Persistent positivity for GAD65A might be associated with increased risk to develop anti-thyroid autoimmunity.