Immunoglobulin E-mediated allergies among children with type 1 diabetes mellitus: a single-center observational study

Background Type 1 diabetes mellitus (T1DM) and immunoglobulin E (IgE)-mediated allergy belong to the most common diseases in the pediatric population, in which they are caused by multifactorial causes. Growing evidence proposes that there is a change in Th1/Th2 balance, and subsequently their associated cytokine response, which is essential during the pathogenesis of autoimmune disorders such as T1DM. Aim To assess clinical characteristics and subsequently risk factors potentiating the IgE-mediated allergy among Egyptian children with T1DM and also to assess serum level of interleukin 5 (IL5) among them. Patients and methods An interviewer-administrated questionnaire was designed to take history of allergy in diabetic children who come to the outpatient clinic fulfilling inclusion criteria and used to collect data. The age range was 5–17 years, with at least 2 years duration of T1DM. Skin prick testing was performed for all diabetic children with history of allergy. Patients were divided into allergic diabetic group (45 patients) and nonallergic diabetic group (45 patients). Laboratory assessment of serum total IgE, IL5, and eosinophils% was carried out. Results Among the 45 allergic diabetic group, 82% were asthmatic cases, 40% of them have allergic rhinitis, and 30% of them have skin allergy. Skin test results showed that allergy to house dust mite showed the highest percentage among the diabetic allergic group (51.1%). The allergic diabetic group showed significantly higher levels of IL5, total IgE, and eosinophils than nonallergic diabetic group (Z=8.13, P<0.001; Z=7.18, P<0.001; and Z=8.02, P<0.001). Conclusion Bronchial asthma is considered the most common type of IgE-mediated allergy that may occur in children with T1DM. Developing IgE allergy in T1DM is dependent on the increased levels of IL5. IL5 was an independent predictor of developing asthma, allergic rhinitis, and skin allergy among our studied cases.