Adult-like but regressive increase of intima-media thickness and roughness in a child with type 1 diabetes.
A 12-yr-old Kosovo-Albanian boy with insufficiently controlled type 1 diabetes since his second year of life developed severely increased intima-media thickness (IMT) and roughness (IMR) of the common carotid artery (CCA): max/mean IMT=0.81/0.68 mm and IMR=0.048 mm. Intima-media thickening, comparable with that in a 50- to 60-yr-old healthy adult, decreased within 41 months (max/mean carotid IMT=0.72/0.56 mm and IMR=0.036 mm) by intensive treatment of diabetes. Moyamoya disease (MMD), complicated by cerebral infarction, occurred coincidentally but regressed within 6 months. This case report points out that (i) chronic hyperglycemia in childhood may lead to adult-like increase of carotid IMT/IMR as early signs of subclinical atherosclerosis, (ii) increased carotid IMT/IMR may be regressive by intensive diabetes control, and (iii) a screening examination for carotid IMT/IMR should be considered in patients at high risk of atherosclerosis.
Krebs
Andreas
A
Department of Pediatrics and Adolescent Medicine, Center for Internal Medicine, Freiburg University Hospital, Freiburg, Germany.
Schmidt-Trucksäss
Arno
A
Wagner
Julia
J
Krebs
Kristin
K
Doerfer
Jürgen
J
Schwab
Karl Otfried
KO
D001479:Basal Ganglia / Q000473:pathology; D002340:Carotid Artery Diseases / Q000453:epidemiology / Q000517:prevention & control; D017536:Carotid Artery, Common / Q000473:pathology*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009072:Moyamoya Disease / Q000453:epidemiology; D017539:Tunica Intima / Q000473:pathology*