title: Revisiting autoimmune gastritis in children and adolescents with type 1 diabetes.
abstract: OBJECTIVE
  Assess the frequency of anti-H+/K+adenosine triphosphatase (ATPase) autoantibodies (AAB) and symptoms of autoimmune gastritis in children and adolescents with type 1 diabetes (T1D).
  
  
  METHODS
  Anti-H+/K+ATPase AAB were measured in 402 children and adolescents (210 boys and 192 girls, 11.1 ± 4.5 years) treated for T1D (screened positive for β-cell AAB), along with search of symptoms of anemia (hemoglobin, serum iron, and ferritin levels) and gastric pain. The AAB specific for thyroperoxydase, thyroglobulin, and transglutaminase were also measured.
  
  
  RESULTS
  Anti-H+/K+ATPase AAB were present in 6.5% of children. Their frequency increased with age: 4% at 10 years, 10% at 15 years, and 20% at 20 years. Iron deficiency (45% vs 3.8%), iron deficiency anemia (36% vs 3.8%), antithyroid AAB (24% vs 9.7%), and family history of Graves' disease (25% vs 5.6%) were more frequent in patients with anti-H+/K+ATPase AAB. Two patients, a 13-year-old girl and a 11-year-old boy, experienced symptoms (iron deficiency anemia and epigastric pain) which led to diagnosis of autoimmune gastritis confirmed upon fibroscopy. Both showed high levels of anti-H+/K+ATPase AAB and atrophic gastritis.
  
  
  CONCLUSIONS
  Autoimmune gastritis presents an age-dependent frequency in children and adolescents with T1D but is rarely symptomatic. Screening for anti-H+/K+ATPase AAB should thus target patients with iron deficiency, anemia, epigastralgia, autoimmune thyroiditis, or age over 15 years.
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France.|Endocrinologie, Gynécologie et Diabétologie Pédiatrique, Hôpital Necker - Enfants Malades, Paris, France.|INSERM U1151, Hôpital Necker - Enfants Malades, Paris, France.|CNRS UMR 8253, Hôpital Necker - Enfants Malades, Paris, France.
authors.forename: Alix
authors.initials: A
authors.lastname: Besançon
authors.affiliation: INSERM U1151, Hôpital Necker - Enfants Malades, Paris, France.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Michaud
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France.|Endocrinologie, Gynécologie et Diabétologie Pédiatrique, Hôpital Necker - Enfants Malades, Paris, France.|INSERM U1016 and IMAGINE Institute, Hôpital Necker - Enfants Malades, Paris, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Beltrand
authors.affiliation: INSERM U1151, Hôpital Necker - Enfants Malades, Paris, France.|CNRS UMR 8253, Hôpital Necker - Enfants Malades, Paris, France.
authors.forename: Tania
authors.initials: T
authors.lastname: Goncalves
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France.|Service de Biostatistiques, Hôpital Necker - Enfants Malades, Paris, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Jais
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France.|Endocrinologie, Gynécologie et Diabétologie Pédiatrique, Hôpital Necker - Enfants Malades, Paris, France.|INSERM U1016 and IMAGINE Institute, Hôpital Necker - Enfants Malades, Paris, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Polak
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France.|INSERM U1151, Hôpital Necker - Enfants Malades, Paris, France.|CNRS UMR 8253, Hôpital Necker - Enfants Malades, Paris, France.|Laboratoire d'immunologie biologie, Hôpital Necker - Enfants Malades, Paris, France.
authors.forename: Lucienne
authors.initials: L
authors.lastname: Chatenoud
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France.|Endocrinologie, Gynécologie et Diabétologie Pédiatrique, Hôpital Necker - Enfants Malades, Paris, France.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Robert
mesh_terms: D000293:Adolescent; D001323:Autoantibodies / Q000276:immunology*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D005260:Female; D005756:Gastritis / Q000276:immunology*; D017506:H(+)-K(+)-Exchanging ATPase / Q000276:immunology*; D006801:Humans; D008297:Male
chemical_list: D001323:Autoantibodies; D017506:H(+)-K(+)-Exchanging ATPase
keywords: adolescents; anti-H+/K+ ATPase autoantibodies; autoimmune gastritis; children; type 1 diabetes