{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T10:19:45Z","timestamp":1697451585589},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2008,10,9]],"date-time":"2008-10-09T00:00:00Z","timestamp":1223510400000},"content-version":"vor","delay-in-days":2883,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2000,11,17]]},"abstract":"<jats:p>Although it is well known that patients with type 1 diabetes mellitus are susceptible to other autoimmune diseases, the simultaneous occurrence of clustered distinct autoimmune diseases is uncommon. We report a 16\u2010year\u2010old girl, previously diagnosed as having coeliac disease and IgA deficiency, who at 13 years of age developed a clustering of distinct autoimmune diseases, including type 1 diabetes mellitus, rheumatoid arthritis (RA) and euthyroid autoimmune thyroiditis, eventually resulting in a simultaneous long\u2010term remission. The clinical picture was associated with a functional immunodeficiency characterized by a defect in proliferative responses to T cell predominant mitogens and a normal response to the B cell predominant mitogen. In addition, the T cell activation markers HLA\u2010DR, IL\u20102 receptor and transferrin receptor) were not upregulated. The clinical course of this immunodeficiency paralleled the outcome of the autoimmune diseases. After the abrupt onset, spontaneous clinical remission of both diabetes mellitus and RA was observed. Insulin was first reduced in dose and then discontinued completely at 15 months, in the presence of normal C peptide secretion and normal metabolic control (HbA1c 5.8%). Anti\u2010glutamate decarboxylase (GAD65) and anti\u2010IA\u20102 antibodies remained persistently high. During the remission phase a normalization of the functional immune defect was observed. The gradual resolution of the multisystemic diseases as well as the normalization of immune function in our patient is unusual. This case may be of considerable value in furthering our knowledge of the immunological mechanisms implicated in these rare multireactive syndromes.<\/jats:p>","DOI":"10.1046\/j.1365-2265.2000.01045.x","type":"journal-article","created":{"date-parts":[[2003,3,11]],"date-time":"2003-03-11T10:47:02Z","timestamp":1047379622000},"page":"649-653","source":"Crossref","is-referenced-by-count":4,"title":["Simultaneous peripubertal onset of multireactive autoimmune diseases with an unusual long\u2010lasting remission of type 1 diabetes mellitus"],"prefix":"10.1111","volume":"53","author":[{"given":"Giuliana","family":"Valerio","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana Franzes\u00e9, Andrea","family":"Iovino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michela","family":"Tanga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Alessio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Pignata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2008,10,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1515\/JPEM.1996.9.S1.113"},{"key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"205","DOI":"10.2337\/diab.45.2.205","article-title":"Immunological and metabolic effects of prophylactic insulin therapy in the NOD\u2010scid\/scid adoptive transfer model of IDDM","volume":"45","author":"Bowman M.A.","year":"1996","journal-title":"Diabetes"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00280884"},{"key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"2871","DOI":"10.1182\/blood.V89.8.2871","article-title":"Deficiency of the Fas apoptosis pathway without Fas\u2010gene mutations in pediatric patients with autoimmunity\/lymphoproliferation","volume":"89","author":"Dianzani U.","year":"1997","journal-title":"Blood"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1006\/clin.1996.0132"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0092-8674(95)90013-6"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(93)90940-I"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.16.1.125"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.82.2.375"},{"key":"e_1_2_8_11_1","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1136\/adc.75.5.410","article-title":"Ketoacidosis at the diagnosis of type 1 (insulin dependent) diabetes mellitus is related to poor residual \u03b2 cell function","volume":"75","author":"Komulainen J.","year":"1996","journal-title":"Archives of Disease in Childhood"},{"key":"e_1_2_8_12_1","unstructured":"Lorini R.&Vanelli M.& the Prediabetes Study Group of the Italian Society for Pediatric Endocrinology and Diabetology (SIEDP). 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