جستجوی مقالات مرتبط با کلیدواژه "دیابت قندی تیپ 1" در نشریات گروه "پزشکی"

Type 1 diabetes mellitus (T1DM) as an autoimmune disease is associated with hyperglycemia and pseudohypoparathyroidism with hypoglycemia. In this study, we report a rare case of association between type 1 diabetes and pseudohypoparathyroidism.

Case Report: 

A 12.5-year-old female patient with a one-month history of polyuria and polydipsia was admitted with severe lethargy and vomiting, and due to high blood sugar and metabolic acidosis, Diabetic Ketoacidosis (DKA) was diagnosed. She was first treated with DKA protocol and then Basal- Bolus Protocol of insulin. The patient had a history of seizures due to hypocalcemia at the ages of 8 days and 2 months. In re-examination during hospitalization due to hypocalcemia-hyperphosphatemia and high parathyroid hormone, the diagnosis of false hypoparathyroidism was proposed and treatment with oral calcium tablet and calcitriol capsule was done and she was discharged after seven days with a good general condition.

In patients with pseudohypoparathyroidism, in the event of a disturbance in glucose status, the pattern is usually hypoglycemia, but in our patient, this association was in the form of hyperglycemia and DKA in the context of T1DM, which is an indication of the rare association of these two diseases. Therefore, one should think about early diagnosis and proper treatment of this rare association.

Celiac disease is a chronic inflammation of small intestine which is caused by an increased permanent sensitivity to a protein named gluten. This protein is present in some cereals such as wheat, barley, and rye. The immunologic response to this protein can cause clinical symptoms in people with specific human leukocyte antigens (HLAs) (including HLADQ2 or HLADQ8). Most studies have reported an increased incidence of celiac disease in patients with diabetes mellitus type I. This study aimed to determine the prevalence of the celiac disease in patients with diabetes mellitus type I under the age of 18 years old.

This cross-sectional, analytic descriptive study was performed on forty children with diabetes mellitus type I in Sanandaj Diabetes Association (Kurdistan University of Medical Sciences), Iran, from September 2012 to September 2013. After obtaining consent from their parents, demographic data, including gender, age, family history of diabetes, duration of illness, symptoms of celiac disease, were recorded in the questionnaire. The measurement of the tissue transglutaminase (tTG) antibody and total immunoglobulin type A in the serum was necessary for the screening of celiac disease. Therefore in the laboratory, 5 ml of the venous blood sample was taken and then the serum levels of tTG antibody (from immunoglobulin type A) and total serum levels of this immunoglobulin were measured by the enzyme-linked immunosorbent assay (ELISA) method. Upper endoscopy with multiple biopsies from small intestine was performed in patients with positive serological screening. Finally, the disease was evaluated by histological finding.

Forty children with diabetes mellitus type I included 19 boys (47.5%) and 21 girls (52.5%) were enrolled in the study. The mean age of these patients was 10.53±4.05. The prevalence of celiac disease was 7.5% in these individuals. In the subjects, there was no significant relationship between gastrointestinal symptoms and celiac disease.

In the present study, the prevalence of the celiac disease in type 1 diabetic patients was 7.5% which is higher than the normal population.