Background: Type 1 diabetes mellitus is characterized by presence of several organ specific autoantibodies. Anti-cyclic citrullinated peptide (anti-CCP) antibody is a promising marker of rheumatoid arthritis (RA) which is known to coincide with autoimmune diabetes. Presence of these antibodies was not investigated in children with type 1 diabetes.
Objective and hypotheses: To evaluate presence of anti-CCP antibodies in children with type 1 diabetes compared to healthy subjects.
Method: Ninety children with type 1 diabetes known to be positive for at least one of the pancreatic islet autoantibodies (group 1, M/F: 46/44; mean age 10.5±3.9 years; diabetes duration 2.1±1.9 years) and 76 control cases (group 2, M/F: 34/42; mean age 9.8±3.7) were included. Presence of antithyroid antibodies and coeliac antibodies were recorded for cases with type 1 diabetes. The groups were compared regarding family history for RA, anti-CCP, as studied by ELISA, and rheumatoid factor levels.
Results: The groups were similar regarding age and gender (P=0.196 and P=0.507 respectively). In group 1, one case (1.1%) was positive for anti-CCP antibody (5 U/ml, normal <4.00 U/ml) while none of the controls was positive (P=0.999). The case, who was 9.5 years old, had no relevant joint complaints or findings. He was diagnosed with type 1 diabetes 2 months ago and showed positivitiy for anti-islet cell antibody, anti-gliadin IgA, and tissue transglutaminase IgA antibodies. However, intestinal biopsy for coeliac disease and RF were negative. Family history for RA and RF positivity was not different between groups 1 and 2 (P=0.626 and P=0.999 respectively). In group 1, positivity rates of antithyroid and coeliac autoantibodies were 19.8 and 10%, respectively.
Conclusion: During childhood, anti-CCP antibodies are rare in type 1 diabetes of short duration. The single case with high anti-CCP level will be followed for rheumatoid arthritis however this positivity might be nonspecific and transient as well.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology