Honar Naser, Karamizadeh Zohreh, Vazirian Majid-Vares, Jahanshahi Keramatallah, Manouchehri Ali, Dehghani Seyed Mohsen, Javaherizadeh Hazhir
Gastroenterohepatology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences. Shiraz, Iran.
Shiraz Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences. Shiraz, Iran; Department of Pediatric Endocrinology, Nemazee Teaching Hospital, Shiraz University of Medical Sciences. Shiraz, Iran.
Rev Gastroenterol Peru. 2019 Oct-Dec;39(4):344-347.
Diabetes mellitus type 1 (T1DM) is one of the childhood diseases with growing prevalence. Various accompanying autoimmune diseases were seen with type 1 diabetes. The most common autoimmune diseases with T1DM are autoimmune thyroiditis and celiac disease. In some reports, autoimmune hepatitis has been reported in association with DM-1.
The aim of this study was to evaluate autoimmune hepatitis autoantibodies in children with T1DM.
In this crosssectional study, 202 children with T1DM were evaluated (47.5% were males and 52.5% were girls). Liver enzymes, autoimmune hepatitis related autoantibodies such as anti-nuclear antibodies (ANA), anti-smooth muscle (ASMA) and anti liver and kidney microsomal antibodies (LKM-1) were measured. Liver ultrasound was done for participants and biopsy of liver was taken for children with increased echogenicity of the liver, hepatomegaly or elevated liver enzymes. Results analyzed by statistical software spss-16, Descriptive statistics and chi-square test, paired T-TEST. Level of less than 5% was considered statistically significant.
In 6 patients ANA and in 4 patients (2%) ASMA was positive,1 patient was ASMA positive but ANA negative. None of the patients were Anti LKM-1 positive. 3 patients had positive ANA and ASMA, and increased liver echogenicity on ultrasound simultaneously. Histological evaluation was showed that 2 patients had findings in favor of autoimmune hepatitis.
Auto antibodies were positive in 10 cases. ANA was positive in 6 (2.97%) of all cases. ASMA was positive in 4 (1.98%) cases. Increased echogenicity was found in 3 cases. Histological evaluation showed 2 patients had biopsy confirmed autoimmune hepatitis. AIH-2 was not seen among our cases.
1型糖尿病（T1DM）是一种患病率不断上升的儿童疾病。1型糖尿病常伴有多种自身免疫性疾病。1型糖尿病最常见的自身免疫性疾病是自身免疫性甲状腺炎和乳糜泻。在一些报道中，自身免疫性肝炎也与1型糖尿病相关。
本研究旨在评估1型糖尿病患儿的自身免疫性肝炎自身抗体。
在这项横断面研究中，对202例1型糖尿病患儿进行了评估（47.5%为男性，52.5%为女性）。检测了肝酶、自身免疫性肝炎相关自身抗体，如抗核抗体（ANA）、抗平滑肌抗体（ASMA）和抗肝肾微粒体抗体（LKM-1）。对参与者进行肝脏超声检查，对肝脏回声增强、肝肿大或肝酶升高的患儿进行肝脏活检。结果采用统计软件spss-16进行分析，采用描述性统计、卡方检验和配对T检验。P值小于5%被认为具有统计学意义。
6例患儿ANA阳性，4例（2%）患儿ASMA阳性，1例患儿ASMA阳性但ANA阴性。所有患儿抗LKM-1均为阴性。3例患儿ANA和ASMA均阳性，且超声显示肝脏回声增强。组织学评估显示2例患儿有支持自身免疫性肝炎的表现。
10例患儿自身抗体阳性。所有病例中6例（2.97%）ANA阳性。4例（1.98%）ASMA阳性。3例发现肝脏回声增强。组织学评估显示2例患儿经活检确诊为自身免疫性肝炎。本研究病例中未发现2型自身免疫性肝炎（AIH-2）。
