الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Type 1 Diabetes Mellitus (T1DM) is a chronic illness characterized by the insufficient production of insulin due to autoimmune destruction of beta cells in the pancreas. T1DM can be considered as one of the most frequent endocrine and metabolic conditions in children.
The frequency of organ specific autoimmunity in patients with type 1 diabetes might be due to multiple immunologic abnormalities.
Type 1 diabetes mellitus (T1DM) is often associated with other autoimmune diseases such as thyroiditis, celiac disease, and vitiligo in a complex syndrome called autoimmune polyglandular syndrome (APS). However, the association with immune thrombocytopenia (ITP) is very rare.
An association between diabetes and thrombocytopenia does not conform to a diagnosis of typical autoimmune polyglandular disease. To our knowledge, only three previous cases have been published in which diabetes was associated with thrombocytopenia, and little is known about the origin of the association.
There are few cases in regarding the association of immune thrombocytopenia with T1DM. It is more frequently found secondary to human immunodeficiency virus or viral hepatitis.
The aim of the current study is to investigate the association of Thrombocytopenia in Children with Insulin- Dependent Diabetes Mellitus in Beni-Suef university hospital.
It is a cross sectional observational study that was carried on 104 children between two to twelve years old in in pediatric endocrinology unit in Beni-Suef university hospital in which All patients were subjected to Detailed medical history obtained from their parents and full clinical examination and will do complete blood count, glycosylated hemoglobin , random blood sugar, antinuclear antibodies ,antiplatelet antibody and anti-thyroid peroxidase antibody after approval of internal ethical committee.
The main results of the study revealed that:
• Family history of DM was found among 56.7% while family history of autoimmune diseases was found in 33.1% of the patients. The most frequent compliant observed was day time polyuria (80.0%) followed by polydipsia (71.2%). None of the patients has history of blood or platelet transfusion.
• Hypoglycemic coma was found in 32.4% of patients, 17.1 % tingling and numbness, 3.8% had fungal infections and only two patients (1.9%) developed proteinuria and one patient had vitiligo.
• ANA was positive in 16.2% of patients while 21.9 % of them had anti-thyroid peroxidase antibodies in their sera. Only one patient had both of them and one patient had positive anti-platelet antibodies.
• Hematological indices of the studied children; Hemoglobin (gm/dl) range from 8.70 to 14.20 with a mean of 11.2029±1.32943. TLC (cells x103) range from 4.10 to 11.00 with a mean of 6.1933±1.68250 (SD). Platelets (cells x103) range from 82.00 to 560.00 with a mean of 300.0286±75.67904 (SD).
• Glycosylated hemoglobin was significantly higher in males than in females (p=.018).
• There were significant negative correlations between age at the onset of DM and platelet counts, based on results we recommend for further studies on larger sample of population to emphasize our conclusion and close monitoring of platelet count in children with IDDM.