title: New-Onset Diabetes Mellitus After Transplantation in a Cynomolgus Macaque (Macaca fasicularis).
abstract: A 5.5-y-old intact male cynomolgus macaque (Macaca fasicularis) presented with inappetence and weight loss 57 d after heterotopic heart and thymus transplantation while receiving an immunosuppressant regimen consisting of tacrolimus, mycophenolate mofetil, and methylprednisolone to prevent graft rejection. A serum chemistry panel, a glycated hemoglobin test, and urinalysis performed at presentation revealed elevated blood glucose and glycated hemoglobin (HbA1c) levels (727 mg/dL and 10.1%, respectively), glucosuria, and ketonuria. Diabetes mellitus was diagnosed, and insulin therapy was initiated immediately. The macaque was weaned off the immunosuppressive therapy as his clinical condition improved and stabilized. Approximately 74 d after discontinuation of the immunosuppressants, the blood glucose normalized, and the insulin therapy was stopped. The animal's blood glucose and HbA1c values have remained within normal limits since this time. We suspect that our macaque experienced new-onset diabetes mellitus after transplantation, a condition that is commonly observed in human transplant patients but not well described in NHP. To our knowledge, this report represents the first documented case of new-onset diabetes mellitus after transplantation in a cynomolgus macaque.
authors: Center for Comparative Medicine, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA. kamatthews@mgh.harvard.edu.
authors: Kristin A
authors: KA
authors: Matthews
authors: Transplant Center, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors: Makoto
authors: M
authors: Tonsho
authors: Transplant Center, Division of Cardiac Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors: Joren C
authors: JC
authors: Madsen
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D048909:Diabetes Complications / Q000175:diagnosis; D003920:Diabetes Mellitus / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D004359:Drug Therapy, Combination; D006442:Glycated Hemoglobin / Q000378:metabolism; D006029:Glycosuria / Q000209:etiology; D006084:Graft Rejection / Q000517:prevention & control*; D016027:Heart Transplantation / Q000009:adverse effects*; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D007328:Insulin / Q000008:administration & dosage; D007662:Ketosis / Q000209:etiology; D008252:Macaca fascicularis; D008297:Male; D023421:Models, Animal; D013950:Thymus Gland / Q000637:transplantation*; D013997:Time Factors
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007166:Immunosuppressive Agents; D007328:Insulin