title: Vanished islets with pancreatitis in acute-onset insulin-dependent diabetes mellitus in an adult.
abstract: We report an autopsy case of acute-onset insulin-dependent diabetes mellitus, type I, that occurred in an adult. The patient died 3 days after the clinical onset of diabetes. Hyperglycemia, ketonuria, and hyperamylasemia were observed at admission. The pathologic examination of the pancreas showed a markedly decreased number of islets, and residual islets were small and shrunken. Diffuse inflammatory cell infiltrates, which were found in islets and also in acini, were mainly T lymphocytes. Shrunken islets were composed of insulin cells, glucagon cells, somatostatin cells, and pancreatic polypeptide cells. A decreased number of zymogen granules in acini were prominent [corrected]. This case suggested that pan-pancreatitis, destroying whole islets and acini, can initiate insulin-dependent diabetes mellitus.
authors.affiliation: Department of Pathology, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Kimura
authors.forename: H
authors.initials: H
authors.lastname: Fujiya
authors.forename: K
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: T
authors.initials: T
authors.lastname: Takahashi
authors.forename: H
authors.initials: H
authors.lastname: Nagura
mesh_terms: D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007515:Islets of Langerhans / Q000473:pathology*; D010179:Pancreas / Q000378:metabolism / Q000473:pathology; D010195:Pancreatitis / Q000150:complications* / Q000378:metabolism / Q000473:pathology*