Measurement of antigliadin antibodies in patients with diabetes mellitus type 1 helped in the selection of patients to undergo jejunal biopsy. Antiendomysial antibodies were highly specific and moderately sensitive in predicting celiac disease. The prevalence of celiac disease was higher in diabetics than in the general population, suggesting the need for regular screening assessment of diabetic children.
OBJETIVO: Avaliar a prevalência da doença celíaca (DC) em crianças e adolescentes com diabetes melito tipo 1 (DM1) atendidos no Serviço de Endocrinologia Pediátrica do Hospital das Clínicas da Universidade Federal de Minas Gerais. SUJEITOS E MÉTODOS: Incluídos no estudo crianças e adolescentes com diagnóstico prévio de DM1 acompanhadas no serviço no período de março de 1999 a abril de 2009, com idades entre zero e 18 anos. Todos foram rastreados para DC na primeira consulta e anualmente. A investigação foi realizada por meio da dosagem dos anticorpos da classe IgA (AGAA) e IgG (AGAG) antigliadina. Os pacientes com AGAA e/ou AGAG acima de duas vezes o valor de referência foram submetidos à biópsia intestinal. RESULTADOS: Foram excluídos 21 pacientes do total inicial de 384. Destes, 50 tiveram a sorologia positiva e 29 foram submetidos à biópsia intestinal. A prevalência encontrada foi de 3,1%. CONCLUSÃO: O rastreamento periódico da DC nos pacientes diabéticos deve ser encorajado, dada sua alta prevalência.
Objective: To present the case of a child with neonatal primary hyperparathyroidism submitted to preoperative image studies that couldn't localize the parathyroid glands.Methods: Report of clinical and laboratory evaluation of neonatal primary hyperparathyroidism in a two-and-a-half-monthold child submitted to preoperative cervical ultrasonography and parathyroid scintigraphy with Technetium-99m-Sestamibi, and subtotal parathyroidectomy at the age of four-and-a -half months.Results: The preoperative images suggested an erroneous diagnosis of parathyroid adenoma. After surgery and pos-operative histopathological exams, hyperplasia of parathyroid glands was confirmed. After two years and a half the child has normal parathyroid function.Conclusions: The cervical ultrasonography and the parathyroid scintigraphy with Technetium-99m-Sestamibi were not useful for preoperative localization of hyperplasied parathyroid glands in the neonatal primary hyperparathyroidism in this case. The subtotal parathyroidectomy has been a successful method for the maintenance of normocalcemy in the patient.J. pediatr. (Rio J.). 1999; 75(4): 271-276: hyperparathyroidism, hyperkalemia, parathyroidectomy, ultrasonography, radionuclide imaging, technetium-tc-99m-sestamibi.
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