ESPE Abstracts (2018) 89 P-P3-269

Graves' Disease in Children with T1DM: A Report of Three Cases

Can Thi Bich Ngoca, Vu Chi Dunga, Bui Phuong Thaoa, Nguyen Ngoc Khanha, Nguyen Thu Haa & Nguyen Phu Datb

aVietnam National Children’s Hospital, Hanoi, Vietnam; bHanoi Medical University, Hanoi, Vietnam

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 1–1.58), 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.

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