Fulminant type 1 diabetes mellitus associated with Coxsackievirus type B1 infection during pregnancy: a case report

J Med Case Rep. 2019 Jun 19;13(1):186. doi: 10.1186/s13256-019-2130-8.

Abstract

Background: Fulminant type 1 diabetes is characterized by an intrinsic insulin deficiency resulting from the severe destruction of pancreatic β cells and it rapidly leads to ketoacidosis. However, the association between fulminant type 1 diabetes in pregnancy and specific viral infections has not been reported.

Case presentation: The patient in this study was a 31-year-old Japanese woman, and at 30 weeks of pregnancy she was admitted with marked fatigue. Fetal bradycardia was noted, and the child was delivered by emergency cesarean section but was stillborn. The maternal blood sugar level was high (427 mg/dL), but the glycated hemoglobin value was 6.2%; therefore, fulminant type 1 diabetes was suspected. Serum antibody testing confirmed a Coxsackievirus B1 infection. The patient in this case had fulminant type 1 diabetes in pregnancy associated with Coxsackievirus B1.

Conclusion: This case highlights that fulminant type 1 diabetes in pregnancy may be associated with Coxsackievirus B1 infection.

Keywords: Antiviral antibody; Coxsackievirus B1; Fulminant type 1 diabetes mellitus; Pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Blood Glucose / metabolism
  • Coxsackievirus Infections / complications*
  • Coxsackievirus Infections / virology
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes, Gestational* / blood
  • Diabetic Ketoacidosis / etiology
  • Enterovirus B, Human
  • Female
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Pregnancy

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human