Slowly Progressive Insulin-Dependent Diabetes in a Patient with Primary Biliary Cirrhosis with Portal Hypertension-Type Progression

Yumie Takeshita; Toshinari Takamura; Oto Inoue; Miki Okumura; Kenichiro Kato; Hajime Sunagozaka; Kuniaki Arai; Hirofumi Misu; Minoru Nakamura; Yasuni Nakanuma; Shuichi Kaneko

doi:10.2169/internalmedicine.51.6477

CASE REPORTS

Slowly Progressive Insulin-Dependent Diabetes in a Patient with Primary Biliary Cirrhosis with Portal Hypertension-Type Progression

Yumie Takeshita, Toshinari Takamura, Oto Inoue, Miki Okumura, Kenichiro Kato, Hajime Sunagozaka, Kuniaki Arai, Hirofumi Misu, Minoru Nakamura, Yasuni Nakanuma, Shuichi Kaneko

Author information

Yumie Takeshita
Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Japan
Toshinari Takamura
Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Japan
Oto Inoue
Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Japan
Miki Okumura
Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Japan
Kenichiro Kato
Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Japan
Hajime Sunagozaka
Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Japan
Kuniaki Arai
Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Japan
Hirofumi Misu
Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Japan
Minoru Nakamura
National Hospital Organization (NHO) Nagasaki Medical Center and Department of Hepatology, Nagasaki University Graduate School of Biochemical Sciences, Japan
Yasuni Nakanuma
Department of Human Pathology, Kanazawa University Graduate School of Medical Science, Japan
Shuichi Kaneko
Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Japan

Keywords: SPIDDM, primary biliary cirrhosis, portal hypertension, anti-centromere antibodies (ACA), CREST syndrome

JOURNAL OPEN ACCESS

2012 Volume 51 Issue 1 Pages 79-82

DOI https://doi.org/10.2169/internalmedicine.51.6477

Details

Abstract

A 73-year-old woman had previously been diagnosed with CREST syndrome, PBC and diabetes. Hepatic fibrosis was not evident, in spite of the transudative ascites and active esophageal varices. ACA were positive, whereas AMA and anti-gp210 antibodies were negative. She showed low urinary excretion of C-peptide and was weakly positive for anti-GAD antibody. She was diagnosed with a form of PBC that progresses via portal hypertension rather than liver failure and with SPIDDM. Her HLA type did not contain risk allele for IDDM or PBC. SPIDDM should be considered when patients with PBC with portal hypertension-type progression develop diabetes.

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