Page 192 - Abstract Book KONIKA 18

Endocrinology

P-ENDO-031
The Role of PTPN22 Gene Polymorphism in Javanese Children
with Type-1 Diabetes Mellitus

Fatimah Arief1, Nur Rochmah1, Muhammad Faizi1, Sukmawati Basuki2
Department of Child Health and Department of Medical Parasitology , Faculty of Medicine Universitas Airlangga/
2
1
Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
Abstract
Background Type-1-diabetes mellitus (T1DM) is characterized by autoimmune destruction of insulin-
producing beta cells of pancreatic islets by CD4+ cytotoxic Τ-lymphocytes. Protein tyrosine phosphatase
nonreceptor type22(PTPN22) encodes the lymphoid-specific-tyrosine-phosphatase(Lyp),an inhibitor of the
activation and proliferation of T lymphocytes. PTPN22 C1858T polymorphism was associated with T1DM
in some populations in Asia dan Caucasian origin. Objective To analyze the C1858T polymorphism in
Javanese children with T1DM. Methods A case-control study was held March-July 2021 in endocrinology
outpatient clinic Dr. Soetomo Hospital and Tropical Disease Center Universitas Airlangga. Inclusion
criteria were T1DM patients who control during periode. The PTPN22 polymorphism was detected by
the PCR-restriction-fragment–length polymorphism(RFLP) method. The piece of PTPN22 gene including
polymorphism at position 1858 was amplified with specifically designed primers, PTPN22 forward:5-
ACTGATAATGTTGCTTCAACGG-3 and PTPN22 reverse:5-TCACCAGCTTCCTCAACCAC-3.
Comparison between 2 groups analyzed by Fisher-exact test.We set p-value<0.05 as significant.
Results There were 64 children included, 32 in T1DM and 32 in control group. Mean of age was 15.05
years-old and mean of onset T1DM was 8.13 years-old. Majority of etnics was Javanese(80%). We found
polymorphism genotype-CC(9.4%) and allele-C(54.6%) more frequent in T1DM group, but polymorphism
genotype-CT(100%) and allele-T(50%) more frequent in control group. The C-allele frequency was 54.6%
in T1DM subjects and the T-allele frequency was 45.4% in T1DM subjects. Comparison between two
group T1DM patients and control, there were no significantly different (P=0.2381). Conclusion Our data
demonstrate that polymorphism PTPN22 genotype-CC and allele-C more frequent in Javanese T1DM
patient. T-allele PTPN22 gene constitute non-significant determinants of genetic predisposition of T1DM.
Keywords: type-1-diabetes mellitus; PTPN22 polymorphism; children

P-ENDO-032
Diabetic Ketoacidosis Triggered by Infection in 14-year-old Girl:
A Case Report

Patrick Ramos Pakpahan, Gabriella Berta Risma
Departement of Child Health, Mardi Waluyo General Hospital, Metro, Lampung, Indonesia

Abstract
Introduction Diabetic ketoacidosis (DKA) is an acute complication in children with diabetes mellitus (DM).
Infectious disease is common risk factor in many cases. Objective To learn how to diagnose and management
of DKA. Case A female child, 14 year 7 month, body weight 36 kg came into emergency room with lost
of consciousness for 7 hours. Before that she felt epigastric pain, nausea, headache, and fever. She lost of
weight in several month, polydipsia, polyuria and polyphagia (triad of diabetic). She felt toothache for about
1 week. Physical examination found patient soporocomatous with kussmaul breathing. White blood cell
count 23.500/mm3, blood glucose level 850 g/dL, pH=7.15, HCO =9.6 mmHg, urinary ketone +1, Hba1C
3
> 14%, and C-peptide 0,6 ng/mL. Patient diagnose with DKA with type 1 diabetes. Patient was given initial
treatment with fluid resuscitation 1500cc NaCl in 1 hour, rapid insulin, Ringer lactat mix with KCl and
antibiotic. Patient admitted to ICU, and after 24 hours patient condition was better. For further treatment
patient was given subcutan insulin. Conclusion There must be awareness among parents and first care doctor
for diabetes mellitus in children, there for decrease risk of DKA due to early diagnostic. Infection is a factor
that we should not forget as a predisposition to the occurrence of DKA when meeting with child who have
DKA. Initial therapy in DKA has important role for outcome and any complications.
Keywords: diabetes mellitus; infection; ketoacidosis

144 KONIKA XVIII Abstract Book