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Question:

From Birmingham, Alabama, USA:

My 4 year old daughter was diagnosed with Type 1 Diabetes at age 2. She was recently also diagnosed with autoimmune thyroid failure and is now on replacement therapy. I am an RN and have extensively researched literature on Polyglandular Autoimmune Syndromes, Schmidt's Syndrome, etc. What I have been unable to find however is: A) does the fact that she has already suffered autoimmune failure of two endocrine systems statistically increase the likelihood that she will develop further autoimmune disorders or does she have the same risk as someone for example who has only suffered failure of one system, and B) does the fact that these failures occurred at such a young age significantly impact her risk of developing further problems? Basically I guess what I am asking is what are the odds that her immune system will stop at only two attacks now that is has started this onslaught?

Answer:

The autoimmune polyglandular syndromes are a group of disorders, not all of whom have Type IA diabetes, that have only been described fairly recently. By far the commonest association is hypothyroidism with diabetes although your daughter is a little young to be an example. So far though there are no probability tables for the likelihood of one or more autoimmune conditions manifesting together or on the possible effect of age of onset. There are a few isolated figures; for example celiac syndrome will be present in about 5% of Type 1 Diabetics and Addison's Disease in about 0.5%. There are no figures so far for the association of, say, vitiligo with pernicious anemia.

What you might want to talk to your daughter's doctor about is getting anti-transglutaminase antibodies assayed as an index of celiac syndrome and anti-21 hydroxylase for Addison's Disease.

DO'B

Original posting 11 Jun 1998
Posted to Thyroid

  
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Last Updated: Tuesday April 06, 2010 15:08:58
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