Page 197 - Abstract Book KONIKA 18

Endocrinology

P-ENDO-041
CTLA 4 Gene Polymorphism in Chilhood Type 1 Diabetes Melitus

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1
Suhasta Nova , Nur Rochmah , Muhammad Faizi , Sukmawati Basuki 2
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2
Department of Child Health and Department of Medical Parasitology , Faculty of Medicine Universitas Airlangga/
Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia

Abstract
Background Type 1 diabetes mellitus (T1DM) is an autoimmune disease, in which CTLA-4 gene
polymorphism plays an important role, especially in T-cell mediated destruction of pancreas islets.
Objective To determine CTLA-4 gene polymorphism in childhood T1DM Methods A cross sectional study
was held from March to July 2021 in Pediatric-endocrinology-outpatient-clinic, Dr. Soetomo Hospital,
Indonesia. Inclusion criteria were T1DM patients who following up during the study. Exclusion criteria were
T1DM patients hospitalized in PICU. The CTLA-4 gene polymorphism was detected by polymerase-chain-
reaction-restriction-fragment–length-polymorphism (PCR-RLFP) method. CTLA-4 CT-60A/G forward was
5’GAT-TTC-TTC-ACC-ACT-ATT-TGG-GAT-ATT-AC3’, and reverse was 5’AGA-TCA-AAA-TGG-CTG-
CAA-GG3’. CTLA-4 CT-1822 forward was 5’TCA-AAG-GGA-TTG-AGC-AGA-TG3’, and reverse was
5’TCC-CAT-GCT-CCT-TTG-TTC-TC3’. Results Thirty-one subjects were included in this study, 12/31
were males and 27/31 were Java ethnic. The mean of age was 15.05 years old, the mean of onset T1DM was
8.13 years old, and the mean of C-peptide was 0.81. The frequency of CTLA4 CT-60A/G;G allele;CTLA4-
CT-1822;T allele polymorphism was 58.1%;50.1%;41.9%;66.1% respectively. The Onset of T1DM on
CTLA-4 CT-60A/G; CTLA-4 CT-1822 polymorphism was 45.42%;32.3% respectively occurs in childhood
period. The frequency of Polymorphism of CTLA-4 CT-60A/G; CT1822 in Java ethnic was 45.2%;35.5%
respectively. Conclusion Most T1DM subjects had CTLA-4 CT-60A/G gene polymorphism. The onset of
T1DM in subjects with CTLA-4 CT-60A/G gene polymorphism mostly occurs during the childhood period.
In Java ethnic, CTLA-4 CT-60A/G gene polymorphism often occurs.
Keywords: type 1 diabetes mellitus; CTLA-4

P-ENDO-042
Children with Hyperthyroidism and Type 1 Diabetes Mellitus: A Case Report

Ivanny Khosasih, Eka Agustia Rini
Department of Pediatrics, Endocrinology Division, Faculty of Medicine, Universitas Andalas/Dr. M. Djamil Hospital,
Padang, West Sumatera, Indonesia

Abstract
Background Autoimmune thyroid disease and type 1 diabetes mellitus (T1DM) are common autoimmune
diseases that frequently appear together. Thyroid disease broadly comprises organ-specific autoimmune
disorders. Thyroid autoimmunity being more prevalent in T1DM patient. Up to 20% percent of patient
with T1DM have positive antithyroid antibodies and/or antithyroglobulin. The prevalence of autoimun
thyroiditis is higher in girl. The relationship between thyroid disorders and diabetes mellitus is characterized
by a complex interaction. Objective To describe a case of children with hyperthyroidism and T1DM.
Case Girl 10 years old with 4 kg weight loss, polyphagia, thirsty, polidipsia, poliuria since 2 months before
admission. She had complained palpitations, sweats and emotional. No history of fever, breathlessness,
vomitus, abdominal pain nor decrease of consiousness. She has known hypertiroid since 2 years ago. Her
grandmother also known hypertiroid but no history of diabetes in family. The patient presented moderately
ill with hypertension, exophthalmus and enlargement of bilateral thyroid gland with size 5 cm in length
and 3 cm in height, rubbery, flat surface, no bruit. The laboratory test with hyperglycemia (>720mg/dL),
asidosis metabolic, ketonuria, low of C peptide (0.97 ng/mL), HbA1C 12.4%, FT4 32.6 pmo/L and TSH
<0.05 nIU/mL. Patient was hospitalized for acute condition according to DKA management and now the
patient continued with insulin subcutaneous, propanolol, tyrozol and captopril. Conclusion Diabetes and
thyroid disorders have been shown to mutually influence each others. In addition, uncontrolled thyroid
disorders can increase the risk of diabetic complications where hyperthyroidsm impairs glycemic control
in diabetic subjects.
Keywords: diabetes; hyperthyroid; children

KONIKA XVIII Abstract Book 149