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Unusual association of diseases/symptoms
A girl with type 1 diabetes and a yellowish appearance
  1. I C L Kremer Hovinga1,
  2. E D Stam1,
  3. M L Mearin2,
  4. D Mul3
  1. 1Department of Pediatrics, 't Lange Land Hospital, Zoetermeer, The Netherlands
  2. 2Department of Pediatric Gastroenterology, Leiden University Medical Center, Leiden, The Netherlands
  3. 3Department of Pediatric Endocrinology, Leiden University Medical Center, Leiden and Juliana Children's Hospital, HAGA Teaching Hospital, The Hague, The Netherlands
  1. Correspondence to I C L Kremer Hovinga, i.c.l.kremer-hovinga{at}lumc.nl

Summary

Type 1 diabetes mellitus in children has been associated with other autoimmune diseases, especially coeliac disease and autoimmune thyroiditis. This association may be the result of a common pathogenic background. We describe the case of a girl with type 1 diabetes mellitus who developed icterus due to autoimmune hepatitis, a disease rarely found in children. Thyroiditis-associated and diabetes-associated autoantibodies were also present. Human leucocyte antigen typing revealed DRB1*03 heterozygosity, which has been associated with the occurrence of both autoimmune hepatitis and type 1 diabetes. This finding implies that similar pathogenic pathways may be involved in different autoimmune diseases including type 1 diabetes and autoimmune hepatitis. The patient was successfully treated with prednisolone and azathioprine. Autoimmune hepatitis can be a serious co-occurring disease in patients with type 1 diabetes.

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Footnotes

  • AIH, autoimmune hepatitis; CMV, cytomegalovirus; EBV, Epstein–Barr virus; PSC, primary sclerosing cholangitis.

  • Competing interests None.

  • Patient consent Obtained.

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