Type 1 diabetes mellitus and Graves' disease in Down's syndrome--a rare combination

Afr J Med Med Sci. 2016 Sep;45(3):299-301.

Abstract

Background: Autoimmune diseases including thyroid. disorders, type 1 diabetes and celiac disease are commoner in persons with Down's syndrome compared with the general population. Coexistent type 1 diabetes and hyperthyroidism in Down's syndrome is however not commonly reported in literature.

Objective: To report a case of a lady presenting with Graves' disease and type 1 diabetes at the same time.

Clinical presentation: We report the case of a 22- year-old lady with Down's syndrome who presented with weight loss, polyuria and polydipsia. Physical examination revealed typical dysmorphicfacies of Down's syndrome and a goitre. Laboratory data revealed hyperglycaemia (random plasma glucose-331 mg/dl). She also had biochemical evidence in keeping with hyperthyroidism and markedly elevated thyroid peroxidase antibodies (>1087.0 IU/ml). She improved after rehydration, insulin therapy and antithyroid drugs.

Conclusion: Coexisting autoimmune diseases may present in patients with Down's syndrome. We advocate for routine screening for diabetes and thyroid dysfunction in ersons with Down's syndrome.

Publication types

  • Case Reports

MeSH terms

  • Autoantibodies / immunology
  • Diabetes Mellitus, Type 1 / complications*
  • Down Syndrome / complications*
  • Female
  • Goiter / etiology
  • Graves Disease / complications*
  • Graves Disease / immunology
  • Humans
  • Hyperthyroidism / etiology
  • Polydipsia / etiology
  • Polyuria / etiology
  • Weight Loss
  • Young Adult

Substances

  • Autoantibodies
  • thyroid microsomal antibodies