T-cell insulitis found in anti-GAD65+ diabetes with residual beta-cell function. A case report.
METHODS
We recently encountered a 65-year-old anti-GAD+ diabetic woman with residual beta-cell function who was proved to have T-cell insulitis. The proportion of CD4+ and CD8+ cells varied among individual islets, although CD4+ cells tended to be the predominant T-cell type in the islets examined. All of the islets examined still contained insulin, suggesting that beta-cell mass may have been preserved.


CONCLUSIONS
It is well known that lymphocytic infiltration of pancreatic islets, a condition referred to as "insulitis," is seen in acute-onset type 1 diabetes at autopsy and in biopsy specimens. However, there have been no proven cases of insulitis in type 1 diabetes with residual beta-cell function. We believe that this is the first type 1 diabetic patient with residual beta-cell function who was proven to have T-cell insulitis. This novel evidence will contribute to the proper classification and treatment of diabetes and to a better understanding of the pathophysiology of type 1 diabetes.
Shimada
A
A
Department of Internal Medicine, Saiseikai Central Hospital, Tokyo, Japan. akirasmd@wa2.so-net.ne.jp
Imazu
Y
Y
Morinaga
S
S
Funae
O
O
Kasuga
A
A
Atsumi
Y
Y
Matsuoka
K
K
D000368:Aged; D001323:Autoantibodies / Q000032:analysis*; D016516:CD4-CD8 Ratio; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology* / Q000473:pathology; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007515:Islets of Langerhans / Q000473:pathology / Q000502:physiology*; D013601:T-Lymphocytes / Q000276:immunology*
D001323:Autoantibodies; D005968:Glutamate Decarboxylase; D006442:Glycated Hemoglobin