Transient anti-GAD antibody positivity and acute pancreatitis with pancreas tail swelling in a patient with susceptible haplotype for type 1 diabetes mellitus.
A 57-year-old man was admitted to our hospital complaining of poor appetite. He had been diagnosed with diabetes mellitus and was anti-GAD antibody (GAD-Ab) negative 1 year previously, at the age of 56 years old. Abdominal CT revealed pancreas tail swelling; elastase-I level was elevated and he was diagnosed with pancreatitis. The level of GAD-Ab was increased and HLA haplotype was DRB1*0901-DQB1*0303, which is seen frequently in type 1 diabetic Japanese patients. However, his endogenous insulin secretion ability was not deteriorated. After elastase-I level and pancreas swelling improved, GAD-Ab returned to a normal range. One year after the onset of pancreas swelling, he was still not in an insulin-dependent state. In this case, transient GAD-Ab positivity with susceptible haplotype for type 1 diabetes mellitus might have been induced by a GAD antigen discharged from the destroyed islet due to pancreatitis.
Kahara
Toshio
T
Department of Internal Medicine, Kahoku Central Hospital, Ishikawa, Japan. kchizu1230@yahoo.co.jp
Takamura
Toshinari
T
Otoda
Toshiki
T
Ishikura
Kazuhide
K
Matsushita
Eiki
E
D000208:Acute Disease; D000888:Antibodies, Anti-Idiotypic / Q000097:blood*; D000941:Antigens / Q000009:adverse effects; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000235:genetics* / Q000276:immunology; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006239:Haplotypes / Q000235:genetics*; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000473:pathology; D010196:Pancreatic Elastase / Q000097:blood; D010195:Pancreatitis / Q000097:blood / Q000000981:diagnostic imaging* / Q000276:immunology; D011859:Radiography
D000888:Antibodies, Anti-Idiotypic; D000941:Antigens; D007328:Insulin; D010196:Pancreatic Elastase; D005968:Glutamate Decarboxylase