title: A case of myocarditis associated with IDDM.
abstract: We report a case of diabetic ketoacidosis (DKA) complicated by acute myocarditis, which was confirmed by cardiac biopsy. A 26-year-old man was hospitalized with severe DKA. On admission, nonspecific ST-T change was noted on the electrocardiogram (ECG). The patient's levels of creatine phosphokinase (CPK) and glutamic oxaloacetic transaminase were slightly elevated, but he did not complain of chest discomfort or symptoms of heart disease. On the first day after admission, ST-T elevation was noted on ECG during treatment of DKA. By cardiac angiography and cardiac biopsy, coronary heart disease was ruled out and postmyocarditic change was histologically confirmed. An episode of upper respiratory viral infection before the onset of acute diabetes suggested that the patient suffered from viral-induced myocarditis and consequent development of IDDM. This possibility was confirmed by the clinical course of ECG change, with elevated CPK and lactate dehydrogenase and a slightly elevated antibody titer for echovirus.
authors.affiliation: Department of Internal Medicine, Fujita Health University School of Medicine, Aichi, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Mokuno
authors.forename: Y
authors.initials: Y
authors.lastname: Sawai
authors.forename: N
authors.initials: N
authors.lastname: Oda
authors.forename: T
authors.initials: T
authors.lastname: Mano
authors.forename: N
authors.initials: N
authors.lastname: Hayakawa
authors.forename: R
authors.initials: R
authors.lastname: Kato
authors.forename: Y
authors.initials: Y
authors.lastname: Itoh
authors.forename: K
authors.initials: K
authors.lastname: Shimazaki
authors.forename: M
authors.initials: M
authors.lastname: Kotake
authors.forename: A
authors.initials: A
authors.lastname: Nakai
authors.forename: S
authors.initials: S
authors.lastname: Hiramitsu
authors.forename: M
authors.initials: M
authors.lastname: Itoh
authors.forename: S
authors.initials: S
authors.lastname: Morimoto
authors.forename: A
authors.initials: A
authors.lastname: Nagasaka
mesh_terms: D000328:Adult; D001706:Biopsy; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000503:physiopathology; D016883:Diabetic Ketoacidosis / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D003927:Diet, Diabetic; D004562:Electrocardiography; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D009205:Myocarditis / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology; D014777:Virus Diseases / Q000150:complications* / Q000473:pathology / Q000503:physiopathology
chemical_list: D007328:Insulin