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Abstract

Background Type 1 diabetes mellitus (T1DM) is a chronic endocrine disorder of autoimmune origin with a predisposition to the development of further autoimmune diseases, including autoimmune adrenal insufficiency (Addison’s disease). Although uncommon and frequently underdiagnosed, it can coexist with T1DM, causing life-threatening complications if undiagnosed. Aim To assess the frequency of autoimmune adrenal insufficiency in children with T1DM and its association with other autoimmune diseases. Methods A cross-sectional study was conducted on 110 children with type 1 diabetes mellitus (T1DM) and 100 age- and sex-matched healthy controls. All participants underwent a full clinical evaluation and laboratory testing, including serum cortisol, adrenocorticotropic hormone, sodium, potassium, glucose, HbA1C, blood gases, and anti-21-hydroxylase antibodies. Thyroid and celiac screening was obtained from the regular follow-up records. Results Anti-21-hydroxylase antibodies were detected in 3.56% of the T1DM group and in none of the controls (p < 0.05). All antibody-positive patients had a diabetes duration exceeding five years and concomitant autoimmune thyroid or celiac disease. These children exhibited higher ACTH levels and lower basal cortisol compared with antibody-negative peers. Mean sodium was lower and potassium relatively higher among diabetic children, though within normal limits. Two cases of overt Addison’s disease were identified. Conclusion Subclinical autoimmune adrenal involvement occurs in a small but notable proportion of pediatric T1DM patients, particularly those with long disease duration and additional autoimmune conditions. Early detection enables timely prevention of adrenal crisis. Longitudinal multicenter studies are recommended for evaluating the disease progression from subclinical to overt clinical Autoimmune adrenal insufficiency.

Article Type

Original Study

Subject Area

Endocrinology

IRB Number

IDE00348

Creative Commons License

Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

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