Rapid-onset type 1 diabetes associated with cytomegalovirus infection and islet autoantibody synthesis.
We report the case of a 59-year-old woman who developed rapid-onset type 1 diabetes associated with a marked increase in anti-glutamic acid decarboxylase antibody titer (317.5 U/ml), mild increase in HbA1c level (6.8%), diabetic ketoacidosis, and cytomegalovirus enterocolitis. She was a heterozygote for HLA class II DRB1*0901-DQA1*03-DQB1*0303, and she had HLA class I A24, which may have contributed to the rapid beta cell destruction. Based on the putative molecular mimicry of GAD65 by cytomegalovirus antigen, we hypothesize that the type 1 diabetes in this case was associated with cytomegalovirus infection.
Osame
Keiichiro
K
Department of Endocrinology and Metabolism, Toranomon Hospital, Tokyo.
Takahashi
Yoshihiko
Y
Takasawa
Hirofumi
H
Watanabe
Shigeru
S
Kishimoto
Miyako
M
Yasuda
Kazuki
K
Kaburagi
Yasushi
Y
Nakanishi
Koji
K
Kajio
Hiroshi
H
Noda
Mitsuhiko
M
D001323:Autoantibodies / Q000378:metabolism*; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D016896:Treatment Outcome
D001323:Autoantibodies; C024211:islet cell antibody