Introduction: The association between ATD and AIG is very poorly characterized in pediatric age. We review the prevalence of the anti-gastric parietal cells antibodies (APCA) in young patients with ATD and we evaluated the development of AIG during follow-up, in order to define the usefulness of these markers for AIG screening in these patients.
Patients and Methods: We evaluated 220 children and adolescents (11.28 ± 6.37 yrs) with ATD (186 and autoimmune thyroiditis, AT and 34 Graves' disease, GD). At ATD diagnosis and annualy thereafter, blood count and PCA levels were measured. In patients positive for PCA, plasma gastrin, cromogranin A, vitamin B12, iron and ferritin levels, H. Pylory antigen were detected. The PCA-positive patients >18 years were invited to perform gastroscopy.
Results: PCA positivity were detected in 10 (4.5%) subjects (5F/5M; 12.6±3.4 yrs). The prevalence of PCA positivity was not significantly different in GD than in AT patients (P=0.9). PCA positivity was detected after 2.7 ± 2.7 yrs of follow-up in AT and 4.4 ± 4.0 yrs in GD (P=0.4). The autoantibodies positive patients were higher in males than females, both in AT and GD (P=0.02 and P=0.03, respectively). At the diagnosis of PCA positivity, five out of 10 PCA-positive patients had iron deficiency, 4 vitamin B12 deficiency, 2 anemia, 3 hypergastrinemia and 2 elevated chromogranin values. Two patient, shower H. pylori infection. Gastroscopy was performed in the 5 ATD and in all patients AIG was confirmed.
Conclusion: ATD and AIG may be associated also in juvenile population. PCAs is a usefull marker to detect the subjects at risk for this condition. Due to the longer life expectancy of the pediatric population and considering the relatively high risk of malignant transformation, an early surveillance monitoring is mandatory for children and adolescents with ATD.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology