Association of Rapid-Onset Type 1 Diabetes and Clinical Acute Pancreatitis Positive for Autoantibodies to the Exocrine Pancreas
- Takao Taniguchi, MD,PHD1,
- Junnya Tanaka, MD1,
- Shuji Seko, MD,PHD1,
- Kazuichi Okazaki, MD,PHD2 and
- Motozumi Okamoto, MD,PHD1
- 1Department of Internal Medicine, Ohtsu Red Cross Hospital, Shiga, Japan
- 2Department of Endoscopic Medicine and Gastroenterology, Kyoto University Faculty of Medicine, Kyoto, Japan
A 24-year-old woman presented with epigastralgia on day 0. About 2 weeks before day 0, she had a low- grade fever for a few days. On day 3, she consulted a clinic, where hyperamylasemia (2.8 multiples of the upper normal limit) and swelling of the pancreas on ultrasonography were detected. The subject’s fasting plasma glucose (FPG) level was 85 mg/dl. Her serum insulin and C-peptide levels, as measured later with the frozen plasma, were 20.5 μU/ml and 7.7 ng/ml, respectively. On day 5, the subject’s serum amylase was 4.58 multiples of the upper normal limit. On day 6, her FPG level was elevated to 370 mg/dl and her urinary ketone showed +++. After treatment with intravenous administration of glucose, insulin, and ulinastatin (serine protease inhibitor) at the clinic, she was referred and admitted to Ohtsu Red Cross Hospital. The subject had no history of diabetes, pancreatitis, or alcohol consumption. Her BMI was 17.2 kg/m2, her serum amylase was …
