Fulminating Onset Type 1 Diabetes with Positivity for Anti-GAD Antibody and Elevated Pancreatic Exocrine Enzyme Concentrations

Toshio KAHARA; Toshinari TAKAMURA; Hitoshi ANDO; Masara SAKURAI; Tsuguhito OTA; Tsuguho MlSAKI; Sakae OBA; Masahara IGUCHI; Kazutoshi KOMORI; Ken-ichi KOBAYASHI

doi:10.2169/internalmedicine.42.517

Toshio KAHARA, Toshinari TAKAMURA, Hitoshi ANDO, Masara SAKURAI, Tsuguhito OTA, Tsuguho MlSAKI, Sakae OBA, Masahara IGUCHI, Kazutoshi KOMORI, Ken-ichi KOBAYASHI

Author information

Toshio KAHARA
The Department of Endocrinology and Metabolism (First Department of Internal Medicine), Kanazawa University Graduate School of Medical Science
Toshinari TAKAMURA
The Department of Endocrinology and Metabolism (First Department of Internal Medicine), Kanazawa University Graduate School of Medical Science
Hitoshi ANDO
The Department of Endocrinology and Metabolism (First Department of Internal Medicine), Kanazawa University Graduate School of Medical Science
Masara SAKURAI
The Department of Endocrinology and Metabolism (First Department of Internal Medicine), Kanazawa University Graduate School of Medical Science
Tsuguhito OTA
The Department of Endocrinology and Metabolism (First Department of Internal Medicine), Kanazawa University Graduate School of Medical Science
Tsuguho MlSAKI
The Department of Internal Medicine, Public Ushitsu Hospital
Sakae OBA
The Department of Internal Medicine, Public Ushitsu Hospital
Masahara IGUCHI
The Department of Internal Medicine, Public Ushitsu Hospital
Kazutoshi KOMORI
The Department of Surgery, Public Ushitsu Hospital
Ken-ichi KOBAYASHI
The Department of Endocrinology and Metabolism (First Department of Internal Medicine), Kanazawa University Graduate School of Medical Science

Keywords: diabetic ketoacidosis, fulminant type 1 diabetes, anti-GAD antibody, pancreatic exocrine enzyme

JOURNAL FREE ACCESS

2003 Volume 42 Issue 6 Pages 517-520

DOI https://doi.org/10.2169/internalmedicine.42.517

Details

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 W/l, lipase 169 U/l and elastase-11, 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 μg/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.
(Internal Medicine 42: 517-520, 2003)

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