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Schilddrüsenerkrankungen und Zöliakie

Früherkennung und Therapie bei pädiatrischen Typ-1-Diabetes-Patienten

Thyroid disorders and celiac disease

Early recognition and treatment of pediatric patients with type 1 diabetes

  • Leitthema
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Der Diabetologe Aims and scope

Zusammenfassung

Bei Kindern und Jugendlichen mit Typ-1-Diabetes treten Autoimmunerkrankungen wie Zöliakie und Autoimmunthyreoiditis überproportional häufig auf. Gemeinsame exponierende oder auslösende Faktoren und auch genetische Determinanten werden für die Ätiopathogenese dieser Autoimmunerkrankungen diskutiert, sind bisher jedoch nicht ausreichend geklärt. In der Regel verlaufen diese Erkrankungen ohne eindeutige klinische Symptomatik, daher kann ihre Früherkennung nur durch regelmäßiges Screening der Patienten mit erhöhtem Risiko erfolgen. Dazu gehört die serologische Bestimmung der spezifischen Autoantikörper. Die Empfehlungen in den nationalen und internationalen Leitlinien dienen dem einheitlichen Vorgehen beim Screening und bei der Behandlungsindikation. Zu spät erkannte Begleiterkrankungen können zu klinisch relevanten Stoffwechselproblemen und weiteren vermeidbaren Komplikationen führen.

Abstract

Celiac disease (CD) and autoimmune thyroiditis (AIT) occur more frequently in children and adolescents with type 1 diabetes than in the background population. Common pathogenetic mechanisms and genetic determinants are discussed; however, no clear explanations for their coincidence are available so far. Both diseases frequently present without apparent clinical symptoms; therefore, serological screening by autoantibody testing is required for early detection. The recommendations in national and international guidelines serve to provide a uniform and standardized screening procedure as well as the treatment of patients with clinically asymptomatic disorders and evidence of autoimmunity. Delay in the detection of associated diseases may lead to clinical relevant but otherwise preventable complications.

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  1. Diabetes-Zentrum für Kinder und Jugendliche, Kinder- und Jugendkrankenhaus AUF DER BULT, Janusz-Korczak-Allee 12, 30173, Hannover, Deutschland

    O. Kordonouri

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Correspondence to O. Kordonouri.

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Kordonouri, O. Schilddrüsenerkrankungen und Zöliakie. Diabetologe 9, 128–134 (2013). https://doi.org/10.1007/s11428-012-0974-2

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