Kontiainen S, Schlenzka A, Koskimies S, Rilva A, Mäenpää J
Department of Pediatrics, Aurora Hospital, Helsinki, Finland.
Diabetes Res. 1990 Apr;13(4):151-6.
Another autoimmune disease was found to accompany insulin dependent diabetes mellitus (IDDM) in 14% of the young diabetics (n = 14) studied. Thyroid autoimmune disease was the most common of the accompanying autoimmune diseases, and was detected in 11% (n = 15) of the patients. Two thirds of the IDDM patients with autoimmune thyroiditis were hypothyroid, one was hyperthyroid, and 20% lacked detectable thyroid antibodies when thyroid disease was diagnosed. Coeliac disease was found in 2% of the patients, and one had Addison's disease. Autoantibodies were found in one third of the patients. Thyroid microsomal antibodies were detected in 22% of the patients, IgA anti-gliadin in 11%, gastric parietal cell antibodies in 3% and rheumatoid factor in 7%. Autoimmune disease and the relevant autoantibodies coexisted in 11% of the patients. Autoimmune disorders and autoantibodies were not associated to any particular HLA type. The distribution of the HLA-types in the patients was unusual in that the frequency of HLA-DR3 was not increased. The value of autoantibody tests in the diagnosis of functional disorders of the thyroid and of coeliac disease are discussed.
在研究的14名年轻胰岛素依赖型糖尿病（IDDM）患者中，发现14%伴有另一种自身免疫性疾病。甲状腺自身免疫性疾病是最常见的伴随自身免疫性疾病，在11%（n = 15）的患者中被检测到。患有自身免疫性甲状腺炎的IDDM患者中有三分之二甲状腺功能减退，1例甲状腺功能亢进，20%在诊断甲状腺疾病时缺乏可检测到的甲状腺抗体。2%的患者患有乳糜泻，1例患有艾迪生病。三分之一的患者发现有自身抗体。22%的患者检测到甲状腺微粒体抗体，11%检测到IgA抗麦醇溶蛋白，3%检测到胃壁细胞抗体，7%检测到类风湿因子。11%的患者同时存在自身免疫性疾病和相关自身抗体。自身免疫性疾病和自身抗体与任何特定的HLA类型均无关联。患者中HLA类型的分布不同寻常，因为HLA - DR3的频率并未增加。文中讨论了自身抗体检测在甲状腺功能紊乱和乳糜泻诊断中的价值。
