Autoimmunthyreoiditis bei Kindern und Jugendlichen mit Diabetes mellitus

Zusammenfassung

Durch eine gemeinsame genetische Suszeptibilität haben Kinder und Jugendliche mit einem Typ-1-Diabetes mellitus ein deutlich höheres Risiko an einer Schilddrüsenautoimmunerkrankung zu erkranken. Dabei ist die Prävalenz einer manifesten Hypothyreose etwa 2– bis 5-mal höher als bei gleichaltrigen gesunden Kindern und Jugendlichen. Häufiger noch sind eine subklinische Hypothyreose oder ein positiver Nachweis von Antikörpern (TPO oder Thyreoglobulin). Daher wird derzeit ein Screening (TSH, TPO-AK) alle 1–2 Jahre empfohlen. Bei subklinischer Thyreoiditis (mehrfach erhöhtes TSH oder sonographische Auffälligkeiten plus Nachweis von Antikörpern) sollte eine Behandlung mit L-Thyroxin begonnen werden.

Summary

Children and adolescents with type 1 diabetes have a high risk to develop thyroid autoimmune disease due to common genetic susceptibility of autoimmune disorders. Therefore the prevalence of hypothyroidism is about 2–5 fold higher in diabetic youth. Even higher is the prevalence of thyroid autoimmunity (i. e. antibody positivity for TPO and thyreoglubulin) and subclinical hypothyroidism. Screening is recommended in Germany every 1–2 years by measuring TSH and Anti-TPO. Subclinical thyroiditis (repeated elevated thyreotropin or sonographic signs of thyreoiditis and thyroid autoimmunity) should be treated with levo-thyroxin.

Schlüsselwörter

Diabetes mellitus - Schilddrüse - Thyreoiditis - TPO-Antikörper

Keywords

Diabetes mellitus - thyroid - autoimmunthyroiditis - TPO-Ab

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