A case of fulminant type 1 diabetes associated with significant elevation of mumps titers.
Type 1 diabetes mellitus is classified as either autoimmune or idiopathic. Fulminant type 1 diabetes was originally reported as a subtype of idiopathic type 1 diabetes. Though involvement of viral infections has been suggested as a triggering mechanism, its pathogenesis remains unknown. Here, we present a case of fulminant type 1 diabetes associated with significant elevation of mumps titers. A 56-year-old Japanese man had suffered from nausea and generalized fatigue for two days before being transferred to our hospital in a confused state. Findings on admission revealed a high blood glucose level, near-normal HbA1c level, metabolic acidosis, and increased urinary ketone levels. Serum tests for islet-associated autoantibodies were negative. The serum, urinary C-peptide levels and the result of glucagon test indicated severe impairment of insulin secretion. These results were compatible with the diagnosis of fulminant type 1 diabetes. Also, he was suspected as having mumps infection on the basis of serological testing. These findings suggest that fulminant type 1 diabetes developed after mumps virus infection in our case. To the best of our knowledge, no other report has indicated an association between a recent mumps infection and the onset of fulminant type 1 diabetes. This case suggests an association between fulminant type 1 diabetes and mumps virus infection.
Department of Diabetes and Metabolic Medicine, International Medical Center of Japan, Tokyo, Japan.
Atsushi
A
Goto
Yoshihiko
Y
Takahashi
Miyako
M
Kishimoto
Yoshifumi
Y
Nakajima
Koji
K
Nakanishi
Hiroshi
H
Kajio
Mitsuhiko
M
Noda
D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000821:virology; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009107:Mumps / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D009109:Mumps virus / Q000276:immunology* / Q000502:physiology*