Neonatal Type I diabetes associated with maternal echovirus 6 infection: a case report

Diabetologia. 2000 Oct;43(10):1235-8. doi: 10.1007/s001250051518.

Abstract

Aims/hypothesis: Neonatal diabetes mellitus is rare, and it has not been associated with beta-cell autoimmunity. Enteroviral infections during pregnancy have been implicated as a risk factor for the later development of Type I (insulin-dependent) diabetes mellitus. We now report of a baby girl who was born severely growth-retarded with neonatal insulin-deficient diabetes, and look for evidence of intrauterine enteroviral infections and beta-cell targeted autoimmunity.

Methods: Diabetes-associated autoimmunity was studied by measurement of several types of islet cell reactive autoantibodies. The infant's T-cell responses to insulin and enterovirus antigens were recorded and enterovirus antibodies were measured both from the mother and the child.

Results: Several types of diabetes-associated autoantibodies were detected postnatally, including insulin autoantibodies, conventional islet cell autoantibodies and glutamic acid decarboxylase antibodies, whereas no autoantibodies were observed in the mother. The infant's T-cells showed reactivity to insulin and purified enterovirus particles. Based on serological studies, the pathogenetic process could have been triggered by an echovirus 6 infection during pregnancy. The patient's diabetes has been permanent, although there were signs of endogenous insulin production for several months. Exocrine pancreatic insufficiency was diagnosed at the age of 1 year.

Conclusion/interpretation: These observations suggests that enteroviral infections may induce beta-cell autoimmunity even in utero.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autoimmunity
  • Diabetes Mellitus, Type 1 / immunology
  • Diabetes Mellitus, Type 1 / virology*
  • Echovirus 6, Human*
  • Echovirus Infections* / immunology
  • Echovirus Infections* / transmission
  • Female
  • Gastroenteritis / complications
  • Gastroenteritis / virology
  • Glutamate Decarboxylase / immunology
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical
  • Insulin / immunology
  • Islets of Langerhans / immunology
  • Pregnancy
  • Pregnancy Complications, Infectious / virology

Substances

  • Insulin
  • Glutamate Decarboxylase