title: Fulminating onset type 1 diabetes with positivity for anti-GAD antibody and elevated pancreatic exocrine enzyme concentrations.
abstract: A 52-year-old man was admitted to our hospital for diabetic ketoacidosis. On admission, Hb(A1c) was 6.5%, anti-GAD antibody 10.3 U/ml, serum amylase 144 IU/l, lipase 169 U/l and elastase-I 1,000 ng/dl. There were no abdominal symptoms, and abdominal CT showed unremarkable findings. He was treated with intensive insulin therapy. After 1 month, urinary excretion of C-peptide was 3.8 microg/day. Serum pancreatic exocrine enzyme concentrations returned to normal after 3 months. After 10 months, anti-GAD antibody had become negative, but insulin therapy was still needed for glycemic control. This report concerns a case of autoimmune fulminating onset type 1 diabetes.
authors.affiliation: Department of Endocrinology and Metabolism (First Department of Internal Medicine), Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641.
authors.forename: Toshio
authors.initials: T
authors.lastname: Kahara
authors.forename: Toshinari
authors.initials: T
authors.lastname: Takamura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ando
authors.forename: Masaru
authors.initials: M
authors.lastname: Sakurai
authors.forename: Tsuguhito
authors.initials: T
authors.lastname: Ota
authors.forename: Tsuguho
authors.initials: T
authors.lastname: Misaki
authors.forename: Sakae
authors.initials: S
authors.lastname: Oba
authors.forename: Masaharu
authors.initials: M
authors.lastname: Iguchi
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Komori
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Kobayashi
mesh_terms: D001219:Aspartate Aminotransferases / Q000097:blood; D001323:Autoantibodies / Q000032:analysis / Q000276:immunology*; D001774:Blood Chemical Analysis; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000188:drug therapy; D016883:Diabetic Ketoacidosis / Q000175:diagnosis* / Q000188:drug therapy; D005500:Follow-Up Studies; D005968:Glutamate Decarboxylase / Q000032:analysis / Q000276:immunology*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000201:enzymology; D018570:Risk Assessment; D012720:Severity of Illness Index; D000637:Transaminases / Q000032:analysis / Q000378:metabolism*; D016896:Treatment Outcome
chemical_list: D001219:Aspartate Aminotransferases; D001323:Autoantibodies; D005968:Glutamate Decarboxylase; D006442:Glycated Hemoglobin; D007328:Insulin; D000637:Transaminases