Fulminating onset type 1 diabetes with positivity for anti-GAD antibody and elevated pancreatic exocrine enzyme concentrations

Intern Med. 2003 Jun;42(6):517-20. doi: 10.2169/internalmedicine.42.517.

Abstract

A 52-year-old man was admitted to our hospital for diabetic ketoacidosis. On admission, Hb(A1c) was 6.5%, anti-GAD antibody 10.3 U/ml, serum amylase 144 IU/l, lipase 169 U/l and elastase-I 1,000 ng/dl. There were no abdominal symptoms, and abdominal CT showed unremarkable findings. He was treated with intensive insulin therapy. After 1 month, urinary excretion of C-peptide was 3.8 microg/day. Serum pancreatic exocrine enzyme concentrations returned to normal after 3 months. After 10 months, anti-GAD antibody had become negative, but insulin therapy was still needed for glycemic control. This report concerns a case of autoimmune fulminating onset type 1 diabetes.

Publication types

  • Case Reports

MeSH terms

  • Aspartate Aminotransferases / blood
  • Autoantibodies / analysis
  • Autoantibodies / immunology*
  • Blood Chemical Analysis
  • Diabetes Mellitus, Type 1 / diagnosis*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetic Ketoacidosis / diagnosis*
  • Diabetic Ketoacidosis / drug therapy
  • Follow-Up Studies
  • Glutamate Decarboxylase / analysis
  • Glutamate Decarboxylase / immunology*
  • Glycated Hemoglobin A / analysis
  • Humans
  • Insulin / therapeutic use
  • Male
  • Middle Aged
  • Pancreas / enzymology
  • Risk Assessment
  • Severity of Illness Index
  • Transaminases / analysis
  • Transaminases / metabolism*
  • Treatment Outcome

Substances

  • Autoantibodies
  • Glycated Hemoglobin A
  • Insulin
  • Transaminases
  • Aspartate Aminotransferases
  • Glutamate Decarboxylase