Objectives: Type one diabetes mellitus (T1DM) is an autoimmune disorder that is yet the most common type of diabetes in children and adolescents. Therefore, children and adolescents with T1DM are at increased risk for developing other autoimmune diseases including Graves disease. Detection of thyroid abnormalities in children is crucial since thyroid dysfunction can affect growth, pubertal maturation, insulin metabolism and gastrointestinal function. Herein, we reported three T1DM cases with Graves disease.
Methods: This is case series report to describle clinical features and laboratory manifestations of patients with diabetes and Graves disease.
Results: Three girls with onset age were at 7.5±4.9 years. All cases admitted with the features of polydipsia, polyuria and weight loss. On admission, they presented with tachycardia, exophthalmus, diffuse goiter grade 3 and low weight with BMI of 13.7, 11.6 and 8.9 kg/m2 respectively. They had not diabetes ketoacidosis and history of diabetes in her family. Laboratories showed that blood glucose levels of 21.7±2.8 mmol/l; HbA1C of 9.99±1.26%; C-peptide 1.17±0.22 nmol/l; T3 4.6±0.5 nmol/l, T4 151.4±32 nmol/l, TSH <0.01 mUI/l, Trab 15±4.9 UI/ml (normal range 11.58), anti TG 1176.3±870.8 UI/l (normal range <115), anti TPO 1024±946 UI/ml (normal range <34). All cases have been treated with insulin, thyrozol and propranolon.
Conclusions: All patients with T1D should be screened for hyperthyroidism to have early diagnosis and treatment.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology