My granddaughter was diagnosed about one year ago with type 1 diabetes. She is now 6-1/2 years old, in Grade One. After the original diagnosis, she was also found to have insufficient thyroid production, then probably celiac disease (to be confirmed by biopsy soon). I would like to be well informed about polyorgan autoimmune syndrome, and to learn how other families manage this condition. Could you provide a bibliography or websites?

A good primer for understanding the Autoimmune Polyglandular Syndrome is the chapter in www.uchsc.edu/misc/diabetes/oxch8.html. It is a little technical as are many of the information sources that you might also find by searching this theme in PubMed; but if you sift through the titles of the reports you will be able to select the ones that have most clinical relevance.

Treating hypothyroidism is a simple problem involving only a daily dose of L-thyroxine by mouth and occasional monitoring of growth and blood Thyroid Stimulating Hormone in the serum. If the small intestine biopsy shows flattening of the lining mucosa, this will confirm the antibody test for celiac syndrome and I am sure that your granddaughter’s diabetes team will then want to start her on a gluten (wheat) free diet. There has been a lot of experience with this over the years and certainly the dietitian in the team will provide detailed and expert help. Perhaps the best way for a grandmother to participate, and important if you are to be a caregiver, would be to sit in on one or more of the visits to the dietitian or at least to arrange to be able to review copies of the dietary instructions provided.

DOB