Otoimmün Hastalığı Olan Çocuklarda Atopi ve Alerjik Hastalık Sıklığı

Abstract

Amaç: Otoimmün hastalıklarla alerjik hastalıkların patogenezi arasında farklılıklar olduğu gösterilmiştir. Otoimmün hastalığı olanlarda alerjik hastalıkların daha az olabileceği ileri sürülmektedir. Bu çalışmada, Tip 1 diyabet (Tip 1 DM) ve otoimmün tiroidit (OT) hastalığı olan çocuklarda atopi sıklığının belirlenmesi amaçlandı.Gereç ve Yöntemler: Hastanemizde Tip 1 DM ve OT tanısı ile takipli çocuklara, Türkçe’ye çevrilmiş “International Study of Asthma and Allergy in Childhood” (ISAAC) soru anketi uygulandı ve deri prik testi yapıldı.Bulgular: Çalışmaya 74Tip 1 DM’li ve 37OT’li toplam 111 hasta dahil edildi. Hastaların %56.8’i (n=63) kız ve yaş ortalaması 12.4 ± 3.7 yıldı. Yaşam boyu hışıltı sıklığı %9 (DM’da %5.4, OT’de %16.2); son bir yılda hışıltı sıklığı %3.6 (DM’da %1.4, OT’de %8.1), yaşam boyu rinit sıklığı %18.9 (DM’da %14.9, OT’de %27); son bir yılda alerjik rinit sıklığı %12.6 (DM’da %9.5, OT’de %18.9), son bir yılda alerjik rinokonjuktivit sıklığı %9.9 (DM’da %5.4, OT’de %18.9) olarak saptandı.Sonuç: Otoimmün tiroiditli hastalarda alerjik rinokonjuktivit semptom sıklığı Tip 1 DM hastalara göre artmış bulundu.

Keywords

• Alerjik rinit, Astım, Otoimmün tiroidit, Sensitizasyon, Tip 1 diyabet mellitus

Frequency of Atopy and Allergic Disorders Among Children with Autoimmune Diseases

Abstract

Objective: The pathogenesis of allergic diseases and autoimmune diseases are different. It has been claimed that the prevalence of allergic disorders may be lower in children with autoimmune diseases. The aim of this study was to determine the prevalence of atopy in children with type 1 diabetes mellitus (DM) and autoimmune thyroiditis (AT).Material and Methods: The ISAAC questionnaire was used in children diagnosed with Type 1 DM and AT at our hospital and skin prick tests were performed.Results: A total of 111 children (74 with Type 1 DM and 37 with AT) were included in the study. 56% of the patients (n=63) were female and the mean age was 12.4 ± 3.7 years. The prevalence of wheeze was 9% at any time (5.4% in DM and 16.2% in AT) and 3.6% for the current period (last 12 months) (1.4% in DM and 8.1 % in AT); the prevalence of rhinitis was 18.9% at any time (14.9% in DM and 27% in AT) and %12.6 for the current period (9.5% in DM and 18.9% in AT); the current allergic rhinoconjunctivitis rate was 9.9% (%5.4 in DM and 18.9% in AT).Conclusion: The frequency of allergic rhinoconjunctivit symptoms is higher in children with AT than in children with Type 1 DM

Keywords

• Allergic rhinitis, Asthma, Autoimmune thyroiditis, Sensitization, Type 1 diabetes mellitus

References

1. Kidd P. Th1/Th2 balance: The hypothesis, its limitations, and implications for health and disease. Altern Med Rev 2003;8: 223-46.
2. Saçkesen C. Allerjik hastalıklarda immünopatogenez. Türkiye Klinikleri Pediatrik Bilimler Dergisi 2007;3:1-4
3. Atkinson MA, Eisenbarth GS. Type 1 diabetes: New perspectives on disease pathogenesis and treatment. Lancet 2001;358:221-9.
4. Cardwell CR, Shields MD, Carson DJ, Patterson CC. A meta- analysis of the association between childhood type 1 diabetes and atopic disease. Diabetes Care 2003;26:2568-74.
5. Caffarelli C, Cavagni G, Pierdomenico R, Chiari G, Spattini A, Vanelli M. Coexistence of IgE-mediated allergy and type 1 diabetes in childhood. Int Arch Allergy Immunol 2004;134:288-94.
6. Meerwaldt R, Odink RJ, Landaeta R, Aarts F, Brunekreef B, Gerritsen J, et al. A lower prevalence of atopy symptoms in children with type 1 diabetes mellitus. Clin Exp Allergy 2002;32:254-5.
7. Amino N, Hidaka Y, Takano T, Izumi Y, Tatsumi K-i, Nakata Y. Association of seasonal allergic rhinitis is high in Graves’ disease and low in painless thyroiditis. Thyroid 2003;13:811-4.
8. Olesen AB, Juul S, Birkebæk N, Thestrup-Pedersen K. Association between atopic dermatitis and insulin-dependent diabetes mellitus: a case-control study. Lancet 2001;357:1749-52.

9. Stromberg LG, Ludvigsson GJ, Bjorksten B. Atopic allergy and delayed hypersensitivity in children with diabetes. J Allergy Clin Immunol 1995;96:188-92.
10. Stene L, Joner G. Atopic disorders and risk of childhood-onset type 1 diabetes in individuals. Clin Exp Allergy 2004;34:201-6.
11. Sheikh A, Smeeth L, Hubbard R. There is no evidence of an inverse relationship between TH2-mediated atopy and TH1-mediated autoimmune disorders: Lack of support for the hygiene hypothesis. J Allergy Clin Immunol 2003;111:131-5.
12. Mattila PS, Tarkkanen J, Saxen H, Pitkäniemi J, Karvonen M, Tuomilehto J. Predisposition to atopic symptoms to inhaled antigens may protect from childhood type 1 diabetes. Diabetes Care 2002;25:865-8.
13. Douek IF, Leech NJ, Gillmor HA, Bingley PJ, Gale EA. Children with type-1 diabetes and their unaffected siblings have fewer symptoms of asthma. Lancet 1999;353:1850.