Insulin-Dependent Diabetes Mellitus Following Acute Pancreatitis Caused by Herpes Simplex Virus; A Case Report.
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Accession number;01A0530503
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| Title;Insulin-Dependent Diabetes Mellitus Following Acute Pancreatitis Caused by Herpes Simplex Virus; A Case Report. |
| Author;
NAGAOKA TADASU
(Toyamakenkoseiren Takaokabyoin Naika)
TERADA MITSUHIRO
(Toyamakenkoseiren Takaokabyoin Naika)
MIYAKOSHI HISATSUGU
(Toyamakenkoseiren Takaokabyoin Naika)
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Journal Title;Journal of the Japan Diabetic Society
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Journal Code:Z0279B
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ISSN:0021-437X
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VOL.44;NO.4;PAGE.335-340(2001)
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| Figure&Table&Reference;FIG.4, TBL.3, REF.16 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;A 26-year-old woman was diagnosed with moderate acute pancreatitis based on abdominal pain, elevated serum amylase, and pancreatic swelling. Plasma glucose on admission was 60mg/dl. Her pancreatitis was treated conservatively with a good clinical course in 3 weeks. One week after leaving hospital, she was readmitted due to severe thirst and high plasma glucose (417mg/dl). HbA1c was 10.1% and her urinary and blood ketone levels were extremely high. These findings and blood gas analysis (pH 7.212) revealed that she had diabetic ketoacidosis. Anti-GAD antibodies and ICA were both negative. HLA locus was DR-4, DR-9. Urinary CPR excretion was 5.2.MU.g/day and a glucagon test showed no response of serum CPR with lowest basal CPR. On first admission, the IgM antibody of the Herpes simplex viruses (HSV) was positive. During first and second admission, IgM antibody titer declined gradually with converse elevation of the HSV IgG antibody titer. After admission, her blood glucose was controlled by intensive insulin therapy. None of the 3 major complications of diabetes mellitus was detected. These findings strongly suggest that HSV infection seriously damages the exocrine and endocrine glands of the pancreas, especially pancreatic B cells, and diabetes in this case was not due to acute pancreatitis. Clinical similarities exist between our case and nonimmune fulminant type 1 diabetes reported by Imagawa et al. To distinguish them correctly, it is important to check for evidence of viral infection. (author abst.) |
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