Abstract
A 16-month-old girl presented with an episode of fever and acute thrombocytopenic purpura caused by a Coxsackie B5 virus. On days 13 to 23, laboratory evidence of diabetes mellitus was present, followed by a 2 1/2-month remission, then by definitive insulin-dependent diabetes. The involvement of virologic, immunologic, and genetic factors in the pathophysiology was substantiated by the following data: (1) Virus-induced glucose intolerance was produced in selected mouse strains. (2) Islet-cell antibodies were found one week before onset of diabetes; however, circulating lymphocytes of the child at that time suppressed insulin release from islets in vitro. (3) Immunogenetic analysis of the child revealed the presence of high-risk genetic markers. It is suggested that the convergence of an insulotropic variant virus, genetic predisposition, and perhaps some uncontrolled adjuvant factors, e.g. steroid therapy and DPT vaccination, may have determined insular damage and anti-islet autoimmune reactions, leading to insulin-dependent diabetes mellitus.
Citations
Mar 1, 1986·Diabetic Medicine : a Journal of the British Diabetic Association·G F Bottazzo
Jan 1, 1984·Journal of Medical Virology·R R MirkovicJ W Yoon
Jul 1, 1995·Diabetes/metabolism Reviews·J W Yoon
Feb 20, 2003·Diabetes/metabolism Research and Reviews·Hee-Sook Jun, Ji-Won Yoon
Oct 1, 1991·Annals of Medicine·J W Yoon
Mar 15, 1983·Klinische Wochenschrift·J Bertrams
Apr 1, 1984·Tissue Antigens·K MiyaiT Tsuruhara
Dec 1, 1994·Journal of Medical Virology·Y KangJ W Yoon
Sep 11, 2004·Viral Immunology·Sally Huber, Arlene I Ramsingh
Nov 15, 2006·Diabetes/metabolism Research and Reviews·Nienke van der WerfJan-Luuk Hillebrands
Jan 1, 1986·Diabetologia·K HelmkeK Federlin
Jan 1, 1989·Genetic Epidemiology·J W YoonR G McArthur
Jan 1, 1985·Acta diabetologica latina·A M AlbertiR Santoro
Sep 1, 1983·European Journal of Pediatrics·T MertensH J Eggers
Dec 18, 2003·Annals of the New York Academy of Sciences·Sisko TauriainenHeikki Hyöty
Sep 14, 2006·Diabetologia·A-K BergG Frisk
Dec 1, 1986·European Journal of Pediatrics·G NigroM Midulla
Oct 12, 2002·Journal of Medical Virology·Hong YinGun Frisk
Dec 29, 2004·The Kaohsiung Journal of Medical Sciences·Cheng-Chong ChouBai-Hsiun Chen
Dec 3, 2010·Journal of Diabetes Investigation·Atsushi FujiyaHiroshi Sobajima
Sep 23, 1997·BioEssays : News and Reviews in Molecular, Cellular and Developmental Biology·A I RamsinghS Tracy
Jan 1, 1985·Archives of Virology·G W JordanN J Schmidt
Apr 22, 2009·Journal of Medical Virology·Annika MoëllGun Frisk
Jan 1, 1996·Nutrition Research Reviews·M J Heinig, K G Dewey
Feb 27, 2004·Diabetic Medicine : a Journal of the British Diabetic Association·K K SalminenH Hyöty
Jan 1, 1989·Pharmacology & Therapeutics·M Itoh
Dec 16, 2006·Virus Research·Asma ElshebaniGun Frisk