An incidence peak of juvenile diabetes. Relation to Coxsackie B virus immune response.
All new cases of insulin dependent diabetes mellitus (IDDM) in children below 15 years of age were recorded prospectively during a 21-year period 1964-1984 in a defined uptake area with a relatively constant child population. The total number of children recorded was 222-111 boys and 111 girls. The number of new cases varied between 4 cases in 1968 and 20 in 1984; in 1983 seventeen new cases were recorded. Specific IgM antibodies against Coxsackie B virus (CBV), types 1-5 were measured by a reverse radioimmunoassay (RIA) technique in 24 consecutive patients collected during the period March 1982-January 1984, some of whom represented the recent period of a very high incidence of diabetes. Sixteen patients (67%) exhibited CBV IgM responses, strongly suggesting a current or recent CBV infection. The titres declined during the first few months of diabetes and seemed to be absent after the first half-year period. Among age-matched non-diabetic children scheduled for elective procedures during the same period, no cases with CBV-IgM antibodies were detected. Only three of the 16 IgM-RIA-positive patients showed a significant rise in the neutralising antibody titre against the same Coxsackie B type. It is concluded that CBV may play a pathogenetic role in induction of IDDM, and possibly more frequently so during periods with a high incidence of diabetes, at least in children below 15 years of age.
D000293:Adolescent; D000914:Antibodies, Viral / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D003384:Coxsackievirus Infections / Q000150:complications / Q000276:immunology*; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D029822:Enterovirus B, Human / Q000276:immunology; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis*; D007223:Infant; D008297:Male; D011446:Prospective Studies; D011863:Radioimmunoassay; D013548:Sweden
D000914:Antibodies, Viral; D007075:Immunoglobulin M