Massive synchronous B-cell necrosis causing type 1 (insulin-dependent) diabetes--a unique histopathological case report.
A 22-year-old Chinese male died in hyperglycaemic coma following a 36-h illness. The only significant pathological findings were in the pancreas where there was a heavy diffuse infiltrate of lymphocytes admixed with numerous eosinophils, macrophages and polymorphs. There appeared to have been massive, recent, synchronous necrosis of insulin-secreting B cells with no destruction of any other pancreatic parenchymal cells. The biochemical findings of severe hyperglycaemia, insulinopoenia, but a normal glycosylated HbA1 were compatible with an acute onset to the patient's diabetes. These features contrast with the very much slower destruction of B cells associated with insulitis seen in "classical" Type 1 (insulin-dependent) diabetes.
D000210:Acute-Phase Reaction / Q000473:pathology*; D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000209:etiology / Q000473:pathology*; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology; D007249:Inflammation / Q000473:pathology*; D007515:Islets of Langerhans / Q000473:pathology*; D008297:Male; D009336:Necrosis