BACKGROUND: Patients with type 1 diabetes (T1D) are more likely to develop other autoimmune diseases than the general population.
OBJECTIVE: To describe additional autoimmunity in a cohort of children and adolescents with T1D, as well as to identify factors associated with the presence of additional autoantibodies (AABs) and of additional autoimmune diseases (AADs).
METHODS: This was a single-center retrospective cohort study of 179 children and adolescents (median age: 9.1 years) diagnosed with T1D between 2014 and 2020 in a specialized center in France. Patients were screened for autoimmune thyroiditis and celiac disease at T1D diagnosis and once every 1-2 years during follow-up. Other AADs and their specific autoantibodies were screened for only if clinical or laboratory signs were present.
RESULTS: At T1D diagnosis, 15.6% of participants presented with at least one type of AAB including antibodies specific to Hashimoto\'s disease (TPOAb and/or TGAb) and/or to celiac disease (tTGAb and/or EMAb). Only 2.8% of participants presented with an AAD as early as T1D diagnosis. The median follow-up was 37 months. The cumulative incidence of AABs and AADs at 2 years of follow-up was, respectively, 3.9% and 5.4%, and it doubled at 3 years of follow-up. Only one patient, also affected by Down syndrome, was diagnosed with 2 AADs. Hashimoto\'s disease was the most frequently diagnosed AAD, followed by celiac disease, both at an asymptomatic stage. Vitiligo and Graves\' disease were also diagnosed in this cohort but affected few patients. Children aged 6-12 years were more likely to present with an AAD at diabetes diagnosis (p = 0.043).
CONCLUSIONS: The high prevalence and incidence of additional autoimmunity in children and adolescents with T1D justifies regular screening of AABs and AADs.

We report clinical, serologic, and immunogenetic studies of a set of monozygotic male twin patients who develop autoimmune thyroiditis and vitiligo associated with the HLA-DRB1*04-DQB1*03:02 and HLA-DRB1*03-DQB1*0201 haplotypes. The patients had detectable anti-thyroid and anti-melanocyte autoantibodies. A critical review is presented regarding the role of MHC II molecules linked to clinical manifestations of various autoimmune diseases displayed in a single patient, as is the case in the twin patients reported here.

UNASSIGNED: Type 1 Diabetes mellitus (T1DM), is an autoimmune condition characterised by antipancreatic antibodies presence. Autoimmune process is also directed against other organs, most frequently against the thyroid gland, intestinal mucosa and the gastric parietal cells.
UNASSIGNED: We have investigated in 121 children with T1DM and mean age ±SD of 11.99±4.63 years (range: 2.0-20.0) the frequency of associated autoimmunity and explored the presence of predictive factors, such as current age, sex, severity at diabetes diagnosis, T1DM duration and family history of autoimmunity.
UNASSIGNED: Associated autoimmunity was present in 28.9% of T1DM patients. Children with associated autoimmunity at diabetes diagnosis were older (p=0.009), and had longer diabetes duration, compared to children without associated autoimmunity (p=0.044). Adolescents with present age 12-20 years had statistically significant higher chance of developing thyroid autoimmunity compared to children aged 1-5 years (p = 0.019). Multiple autoimmunity (MA) (T1DM and >2 autoimmune diseases) was present in 5.8% of the study population. All children with MA presented with ketoacidosis at diabetes diagnosis. They also had higher percentage of familial autoimmunity (p = 0.042), had more frequently ≥ 3 relatives with autoimmunity (p=0.026) and were more frequently diagnosed before 5 years of age (p=NS).
UNASSIGNED: Associated autoimmunity was present in almost one third of T1DM patients, with longer diabetes duration, female sex, older age at diabetes diagnosis and glutamic acid decarboxylase (GADA) positivity. Predictors of multiple autoimmunity were age at T1DM diagnosis < 5 years, diabetic ketoacidosis at diagnosis and the presence of a significant family history of autoimmunity.

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