Skip to main content
Top
Published in: Diabetology & Metabolic Syndrome 1/2014

Open Access 01-12-2014 | Research

Autoimmune hepatitis related autoantibodies in children with type 1 diabetes

Authors: Abdulrahman A Al-Hussaini, Musa D Alzahrani, Ahmed S Alenizi, Nimer M Suliman, Mannan A Khan, Sahar A Alharbi, Aziz A Chentoufi

Published in: Diabetology & Metabolic Syndrome | Issue 1/2014

Login to get access

Abstract

Background and objectives

The frequency of Type 1 diabetes (T1D)-related autoantibodies was determined in children with autoimmune hepatitis. However, the incidence of autoimmune hepatitis related autoantibodies in children with T1D has been poorly investigated. The aim of the present cross sectional prospective study was to determine the occurrence of autoimmune hepatitis-related autoantibodies in children with T1D.

Methods

Children with T1D following in diabetic clinic in our center were screened for existence of liver related autoantibodies from November 2010 to November 2011. The patients’ sera were analyzed for the existence of autoantibodies such as anti-nuclear antibody, anti-smooth muscle antibody, and anti-Liver Kidney microsomal antibody, using enzyme linked immunoassay and indirect immunofluorescence methods. A titer of anti-nuclear antibody ≥1/40 was considered positive and titer of < 1/40 was considered negative. Anti-liver kidney microsomal antibody titer of < 3 U/ml was considered negative, 3 – 5 U/ml borderlines, and > 5 U/ml was considered positive.

Results

106 children with T1D have been examined over a one-year period: age ranges between 8 months to 15.5 years, sixty two patients were females. Autoantibody screen revealed a girl with positive anti-liver kidney microsomal antibody (1%) and 8 children had positive anti-nuclear antibody (7.5%), without clinical, biochemical or radiologic evidence of liver disease. None of the patients had positive smooth muscle antibody.

In conclusion

Anti-liver kidney microsomal antibody is rarely found in sera of children with T1D; the clinical significance of which is unknown.
Appendix
Available only for authorised users
Literature
1.
go back to reference Barker JM, Yu J, Yu L, Wang J, Miao D, Bao F, Hoffenberg E, Nelson JC, Gottlieb PA, Rewers M, Eisenbarth GS: Autoantibody “subspecificity” in type 1 diabetes. Diabetes Care. 2005, 28: 850-855. 10.2337/diacare.28.4.850.CrossRefPubMed Barker JM, Yu J, Yu L, Wang J, Miao D, Bao F, Hoffenberg E, Nelson JC, Gottlieb PA, Rewers M, Eisenbarth GS: Autoantibody “subspecificity” in type 1 diabetes. Diabetes Care. 2005, 28: 850-855. 10.2337/diacare.28.4.850.CrossRefPubMed
2.
go back to reference Barker JM: Clinical review: type 1 diabetes associated autoimmunity: natural history, genetic association, and screening. J Clin Endocrinol Metab. 2006, 9: 1210-1217.CrossRef Barker JM: Clinical review: type 1 diabetes associated autoimmunity: natural history, genetic association, and screening. J Clin Endocrinol Metab. 2006, 9: 1210-1217.CrossRef
3.
go back to reference Choudhri K, Vergani G, Vergani GM: Immunological cross-reactivity to multiple auto antigens in patients with liver kidney microsomal type1 autoimmune hepatitis. Hepatology. 1998, 28: 1177-1181. 10.1002/hep.510280502.CrossRef Choudhri K, Vergani G, Vergani GM: Immunological cross-reactivity to multiple auto antigens in patients with liver kidney microsomal type1 autoimmune hepatitis. Hepatology. 1998, 28: 1177-1181. 10.1002/hep.510280502.CrossRef
4.
go back to reference Maggiore G, Bernard O, Homberg JC, Hadchouel M, Alvarez F, Hadchouel P, Odièvre M, Alagille D: Liver disease associated with anti-liver kidney microsome antibody in children. J Pediatr. 1986, 108: 399-404. 10.1016/S0022-3476(86)80880-0.CrossRefPubMed Maggiore G, Bernard O, Homberg JC, Hadchouel M, Alvarez F, Hadchouel P, Odièvre M, Alagille D: Liver disease associated with anti-liver kidney microsome antibody in children. J Pediatr. 1986, 108: 399-404. 10.1016/S0022-3476(86)80880-0.CrossRefPubMed
5.
go back to reference da Silva ME, Porta G, Goldberg AC, Bittencourt PL, Fukui RT, Correia MR, Miura IK, Pugliese RS, Baggio VL, Cançado EL, Kalil J, Santos RF, Rochal DM, Wajchenberg BL, Ursich MJ, Rosenbloom AL: Diabetes mellitus-related autoantibodies in childhood autoimmune hepatitis. J Pediatr Endocrinol Metab. 2002, 15: 1574-CrossRef da Silva ME, Porta G, Goldberg AC, Bittencourt PL, Fukui RT, Correia MR, Miura IK, Pugliese RS, Baggio VL, Cançado EL, Kalil J, Santos RF, Rochal DM, Wajchenberg BL, Ursich MJ, Rosenbloom AL: Diabetes mellitus-related autoantibodies in childhood autoimmune hepatitis. J Pediatr Endocrinol Metab. 2002, 15: 1574-CrossRef
6.
go back to reference De Block CE, De Leeuw IH, Pelckmans PA, Michielsen PP, Bogers JJ, Van Marck EA, Van Gaal LF: Autoimmune hepatitis, autoimmune gastritis, and gastric carcinoid in a type 1 diabetic patient. J Diabetes Complications. 2002, 14: 116-120.CrossRef De Block CE, De Leeuw IH, Pelckmans PA, Michielsen PP, Bogers JJ, Van Marck EA, Van Gaal LF: Autoimmune hepatitis, autoimmune gastritis, and gastric carcinoid in a type 1 diabetic patient. J Diabetes Complications. 2002, 14: 116-120.CrossRef
7.
go back to reference Oki K, Yamane K, Koide J, Mandai K, Nakanishi S, Fujikawa R, Kohno N: A case of polyglandular autoimmune syndrome type III complicated with autoimmune hepatitis. Endocr J. 2006, 53: 705-709. 10.1507/endocrj.K05-166.CrossRefPubMed Oki K, Yamane K, Koide J, Mandai K, Nakanishi S, Fujikawa R, Kohno N: A case of polyglandular autoimmune syndrome type III complicated with autoimmune hepatitis. Endocr J. 2006, 53: 705-709. 10.1507/endocrj.K05-166.CrossRefPubMed
8.
go back to reference Allen S, Huber J, Devendrac D: Prevalence of organ-specific autoantibodies in childhood- and adult-onset type 1 diabetes. Ann N Y Acad Sci. 2008, 1150: 260-262. 10.1196/annals.1447.003.CrossRefPubMed Allen S, Huber J, Devendrac D: Prevalence of organ-specific autoantibodies in childhood- and adult-onset type 1 diabetes. Ann N Y Acad Sci. 2008, 1150: 260-262. 10.1196/annals.1447.003.CrossRefPubMed
9.
go back to reference Heras P, Mantzioros M, Mendrinos D, Heras V, Hatzopoulos A, Xourafas V, Kritikos K, Karagiannis S: Autoantibodies in type 1 diabetes. Diabetes Res Clin Pract. 2010, 90: e40-e42. 10.1016/j.diabres.2010.08.015.CrossRefPubMed Heras P, Mantzioros M, Mendrinos D, Heras V, Hatzopoulos A, Xourafas V, Kritikos K, Karagiannis S: Autoantibodies in type 1 diabetes. Diabetes Res Clin Pract. 2010, 90: e40-e42. 10.1016/j.diabres.2010.08.015.CrossRefPubMed
10.
go back to reference Konus OL, Ozdemir A, Akkaya A, Erbas G, Celik H, Isik S: Normal liver, spleen and kidney dimensions in neonates, infants and children: evaluation with sonography. Am J Roentgenol. 1998, 171: 1693-1698. 10.2214/ajr.171.6.9843315.CrossRef Konus OL, Ozdemir A, Akkaya A, Erbas G, Celik H, Isik S: Normal liver, spleen and kidney dimensions in neonates, infants and children: evaluation with sonography. Am J Roentgenol. 1998, 171: 1693-1698. 10.2214/ajr.171.6.9843315.CrossRef
11.
go back to reference De Block CEM, Van Gaal LF, De Leeuw IH: High prevalence of manifestations of gastric autoimmunity in parietal cell antibodies positive type 1 (Insulin-dependent) diabetic patients. J Pediatr Endocrinol Metab. 1999, 84: 4062-4067. De Block CEM, Van Gaal LF, De Leeuw IH: High prevalence of manifestations of gastric autoimmunity in parietal cell antibodies positive type 1 (Insulin-dependent) diabetic patients. J Pediatr Endocrinol Metab. 1999, 84: 4062-4067.
12.
go back to reference Komurasaki R, Imaoka S, Tada N, Okada K, Nishiguchi S, Funae Y: LKM-1 sera from autoimmune hepatitis patients that recognize ERp57, carboxylesterase 1 and CYP2D6. Drug Metab Pharmacokinet. 2010, 25: 84-92. 10.2133/dmpk.25.84.CrossRefPubMed Komurasaki R, Imaoka S, Tada N, Okada K, Nishiguchi S, Funae Y: LKM-1 sera from autoimmune hepatitis patients that recognize ERp57, carboxylesterase 1 and CYP2D6. Drug Metab Pharmacokinet. 2010, 25: 84-92. 10.2133/dmpk.25.84.CrossRefPubMed
13.
go back to reference Yamamoto AM, Cresteil D, Homberg JC: Characterization of the anti-liver kidney microsome antibody (anti-LKM1) from hepatitis C virus-positive and –negative sera. Gastroenterology. 1993, 104: 1762-1767.PubMed Yamamoto AM, Cresteil D, Homberg JC: Characterization of the anti-liver kidney microsome antibody (anti-LKM1) from hepatitis C virus-positive and –negative sera. Gastroenterology. 1993, 104: 1762-1767.PubMed
14.
go back to reference Muratori L, Lenzi M, Ma Y, Cataleta M, Mieli-Vergani G, Vergani D, Bianchi FB: Heterogeneity of liver/kidney microsomal antibody type1 in autoimmune hepatitis and hepatitis C virus related liver disease. Gut. 1995, 37: 406-412. 10.1136/gut.37.3.406.PubMedCentralCrossRefPubMed Muratori L, Lenzi M, Ma Y, Cataleta M, Mieli-Vergani G, Vergani D, Bianchi FB: Heterogeneity of liver/kidney microsomal antibody type1 in autoimmune hepatitis and hepatitis C virus related liver disease. Gut. 1995, 37: 406-412. 10.1136/gut.37.3.406.PubMedCentralCrossRefPubMed
15.
go back to reference Bonifacio E, Bingley PJ, Shattock M, Dean BM, Dunger D, Gale EA, Bottazzo GF: Quantification of islet-cell antibodies and prediction of insulin-dependent diabetes. Lancet. 1990, 335: 147-149. 10.1016/0140-6736(90)90013-U.CrossRefPubMed Bonifacio E, Bingley PJ, Shattock M, Dean BM, Dunger D, Gale EA, Bottazzo GF: Quantification of islet-cell antibodies and prediction of insulin-dependent diabetes. Lancet. 1990, 335: 147-149. 10.1016/0140-6736(90)90013-U.CrossRefPubMed
16.
go back to reference Czaja AJ: Behavior and significance of autoantibodies in type 1 autoimmune hepatitis. J Hepatol. 1999, 30: 394-401. 10.1016/S0168-8278(99)80096-8.CrossRefPubMed Czaja AJ: Behavior and significance of autoantibodies in type 1 autoimmune hepatitis. J Hepatol. 1999, 30: 394-401. 10.1016/S0168-8278(99)80096-8.CrossRefPubMed
17.
go back to reference Zachou K, Muratori P, Koukoulis GK, Granito A, Gatselis N, Fabbri A, Dalekos GN, Muratori L: Review article: autoimmune hepatitis – current management and challenges. Aliment Pharmacol Ther. 2013, 38: 887-913. 10.1111/apt.12470.CrossRefPubMed Zachou K, Muratori P, Koukoulis GK, Granito A, Gatselis N, Fabbri A, Dalekos GN, Muratori L: Review article: autoimmune hepatitis – current management and challenges. Aliment Pharmacol Ther. 2013, 38: 887-913. 10.1111/apt.12470.CrossRefPubMed
18.
go back to reference Tan EM, Feltkamp TE, Smolen JS: Range of antinuclear antibodies in “healthy individuals”. Arthritis Rheum. 1997, 40: 1601-1611. 10.1002/art.1780400909.CrossRefPubMed Tan EM, Feltkamp TE, Smolen JS: Range of antinuclear antibodies in “healthy individuals”. Arthritis Rheum. 1997, 40: 1601-1611. 10.1002/art.1780400909.CrossRefPubMed
19.
go back to reference Toh BH: Anti-cytoskeletal autoantibodies: diagnostic significance for liver diseases, infections and systemic autoimmune diseases. Autoimmunity. 1991, 11: 119-125. 10.3109/08916939109035142.CrossRefPubMed Toh BH: Anti-cytoskeletal autoantibodies: diagnostic significance for liver diseases, infections and systemic autoimmune diseases. Autoimmunity. 1991, 11: 119-125. 10.3109/08916939109035142.CrossRefPubMed
20.
go back to reference Mieli-Vergani G, Vergani D: Autoimmune liver diseases in children - what is different from adulthood?. Best Pract Res Clin Gastroenterol. 2011, 25: 783-795. 10.1016/j.bpg.2011.10.007.CrossRefPubMed Mieli-Vergani G, Vergani D: Autoimmune liver diseases in children - what is different from adulthood?. Best Pract Res Clin Gastroenterol. 2011, 25: 783-795. 10.1016/j.bpg.2011.10.007.CrossRefPubMed
Metadata
Title
Autoimmune hepatitis related autoantibodies in children with type 1 diabetes
Authors
Abdulrahman A Al-Hussaini
Musa D Alzahrani
Ahmed S Alenizi
Nimer M Suliman
Mannan A Khan
Sahar A Alharbi
Aziz A Chentoufi
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Diabetology & Metabolic Syndrome / Issue 1/2014
Electronic ISSN: 1758-5996
DOI
https://doi.org/10.1186/1758-5996-6-38

Other articles of this Issue 1/2014

Diabetology & Metabolic Syndrome 1/2014 Go to the issue