Clinical heterogeneity among pediatric patients with autoimmune type 1 diabetes stratified by immunoglobulin deficiency.

BACKGROUND: Type 1 diabetes (T1D) may coexist with primary immunodeficiencies, indicating a shared genetic background. OBJECTIVE: To evaluate the prevalence and clinical characteristics of immunoglobulin deficiency (IgD) among children with T1D. METHODS: Serum samples and medical history questionnaires were obtained during routine visits from T1D patients aged 4-18 years. IgG, IgA, IgM, and IgE were measured by nephelometry and enzyme-linked immunosorbent assay (ELISA). IgG and IgM deficiency (IgGD, IgMD) were defined as IgG/IgM >2 standard deviations (SD) below age-adjusted mean. IgE deficiency was defined as IgE <2 kIU/L. IgA deficiency (IgAD) was defined as IgA >2 SD below age-adjusted mean irrespective of other immunoglobulin classes (absolute if <0.07 g/L, partial otherwise) and as selective IgAD when IgA >2 SD below age-adjusted mean with normal IgG and IgM (absolute if <0.07 g/L, partial otherwise). RESULTS: Among 395 patients (53.4% boys) with the median age of 11.2 (8.4-13.7) and diabetes duration 3.6 (1.1-6.0) years, 90 (22.8%) were found to have hypogammaglobulinemia. The IgGD and IgAD were the most common each in 40/395 (10.1%). Complex IgD was found in seven patients. Increased odds of infection-related hospitalization (compared to children without any IgD) was related to having any kind of IgD and IgAD; OR (95%CI) = 2.1 (1.2-3.7) and 3.7 (1.8-7.5), respectively. Furthermore, IgAD was associated with having a first-degree relative with T1D OR (95%CI) = 3.3 (1.4-7.6) and suffering from non-autoimmune comorbidities 3.3 (1.4-7.6), especially neurological disorders 3.5 (1.2-10.5). CONCLUSIONS: IgDs frequently coexist with T1D and may be associated with several autoimmune and nonimmune related disorders suggesting their common genetic background.

[Level of interleukin-12 and interferon gamma in blood serum of children with neoplasms and allergy]. / Stezenie interleukiny 12 i interferonu gamma w surowicy dzieci z choroba nowotworowa i alergia.

UNLABELLED: Interleukin-12 (IL-12) shows strong antineoplasm properties. THE AIM: of the study was to evaluate concentration of IL-2 in children's serum with malignant disease, association cytokines with the presence allergic reaction. MATERIAL AND METHODS: We analysed 100 patients with malignant disease, and/or with allergy (NA+/NA-, respectively), 100 children with allergic disease (A). The control group was 48 healthy cases (K). In all cases were performed skin prick-tests. Concentration of total IgE (t-IgE), IL-12 and INFgamma determined by using ELISA method. RESULTS: T-IgE concentration was to higher in children with allergy disease compared with healthy cases. To low concentration of IL-12 observed in children's group with malignant and allergy disease compared with the other cases ((NA+) = 123,7 pg/ml, (NA-) = 181,7 pg/ ml, (A) = 167,7 pg/ml, (K) = 154,2 pg/ml, Me respectively). Higher point of INFgamma observed in children with malignant and allergic disease compared with groups with malignant disease but without allergic disease, allergic disease and healthy cases (Me = 0,95 pg/ml, Me = 0.0 pg/ml, Me = 0,28 pg/ml, Me = 0,55 pg/ml, respectively). CONCLUSION: Coexistence malignant process and allergy describes the interference of synthesis IL-12 and increase t-IgE thus prevelance of humoral reaction.