A girl with type 1 diabetes and a yellowish appearance.
Type 1 diabetes mellitus in children has been associated with other autoimmune diseases, especially coeliac disease and autoimmune thyroiditis. This association may be the result of a common pathogenic background. We describe the case of a girl with type 1 diabetes mellitus who developed icterus due to autoimmune hepatitis, a disease rarely found in children. Thyroiditis-associated and diabetes-associated autoantibodies were also present. Human leucocyte antigen typing revealed DRB1*03 heterozygosity, which has been associated with the occurrence of both autoimmune hepatitis and type 1 diabetes. This finding implies that similar pathogenic pathways may be involved in different autoimmune diseases including type 1 diabetes and autoimmune hepatitis. The patient was successfully treated with prednisolone and azathioprine. Autoimmune hepatitis can be a serious co-occurring disease in patients with type 1 diabetes.
Department of Pediatrics, 't Lange Land Hospital, Zoetermeer, The Netherlands. i.c.l.kremer-hovinga@lumc.nl
I C L Kremer
IC
Hovinga
E D
ED
Stam
M L
ML
Mearin
D
D
Mul
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001323:Autoantibodies / Q000097:blood; D001379:Azathioprine / Q000627:therapeutic use; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D004359:Drug Therapy, Combination; D005260:Female; D006580:Genetic Carrier Screening; D059811:HLA-DRB1 Chains / Q000235:genetics; D019693:Hepatitis, Autoimmune / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007565:Jaundice / Q000188:drug therapy / Q000209:etiology* / Q000235:genetics; D011239:Prednisolone / Q000627:therapeutic use; D013967:Thyroiditis, Autoimmune / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics
D000893:Anti-Inflammatory Agents; D001323:Autoantibodies; D059811:HLA-DRB1 Chains; D007166:Immunosuppressive Agents; D007328:Insulin; D011239:Prednisolone; D001379:Azathioprine