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
2003 Internal medicine (Tokyo. 1992)  
A 52-year-old man was admitted to our hospital for diabetic ketoacidosis. On admission, HbAic was 6.5%, anti-GAD antibody 10.3 U/ml, serum amylase 144 IU//, lipase 169 XJ/l and elastase-1 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 jig/day. Serum pancreatic exocrine enzyme concentrations returned to normal after 3 months. After 10 months,
more » ... 10 months, anti-GAD antibody had become negative, but insulin therapy was still needed for glycemic control. This report concerns a case of autoimmunefulminating onset type 1 diabetes. (Internal Medicine 42: 517-520, 2003) Key words: diabetic ketoacidosis, fulminant type 1 diabetes, anti-GAD antibody, pancreatic exocrine enzyme potassium of 3.8 mEq/Z, chloride of 102 mEq/Z,
doi:10.2169/internalmedicine.42.517 fatcat:cng3ip3tajg2pkvwqolrz45ca4