title: Simultaneous onset of type 1 diabetes mellitus and painless thyroiditis following acute pancreatitis.
abstract: A 24-year-old female suffered from acute pancreatitis, followed by simultaneous onset of painless goiter, elevation of thyroid hormones and diabetic ketoacidosis. Two months later, her insulin secreting function was severely decreased and positive for anti-GAD and anti-islet cell antibodies, whereas the serum glucagon level was normal, suggesting an autoimmune-related destruction specifically of beta cells. In addition, the initial hyperthyroid state was followed by a hypothyroid phase which later recovered to an euthyroid state, suggesting an initial destruction of thyroid cells. Because anti-thyroidal antibodies were positive, it is likely that the thyroidal destruction was also autoimmune-related. This case implies common pathogenic mechanisms in the autoimmunity related destruction of beta cells and thyroid cells.
authors.affiliation: Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, Shogoin.
authors.forename: G
authors.initials: G
authors.lastname: Inoue
authors.forename: T
authors.initials: T
authors.lastname: Sakurai
authors.forename: K
authors.initials: K
authors.lastname: Tanaka
authors.forename: T
authors.initials: T
authors.lastname: Akamizu
authors.forename: H
authors.initials: H
authors.lastname: Masuzaki
authors.forename: K
authors.initials: K
authors.lastname: Hosoda
authors.forename: T
authors.initials: T
authors.lastname: Hayashi
authors.forename: Y
authors.initials: Y
authors.lastname: Yoshimasa
authors.forename: K
authors.initials: K
authors.lastname: Nakao
mesh_terms: D000208:Acute Disease; D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000209:etiology*; D005260:Female; D006801:Humans; D010195:Pancreatitis / Q000150:complications*; D013966:Thyroiditis / Q000150:complications / Q000209:etiology*; D013997:Time Factors