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Islet cell related antibodies and type 1 diabetes associated with echovirus 30 epidemic: A case report.

Cabrera-Rode E, Sarmiento L, Molina G, Perez C, Arranz C, Galvan JA, Prieto M, Barrios J, Palomera R, Fonseca M, Mas P, Diaz-Diaz O, Diaz-Horta O.

Department of Immunology of Diabetes, National Institute of Endocrinology, Havana, Cuba.

Type 1 diabetes associated genes account for less than 50% of disease susceptibility. Human enteroviruses have been implicated as environmental factors that might trigger and/or accelerate this autoimmune disorder. We now report of a 12-year-old girl that developed pancreatic autoimmunity and type 1 diabetes after enteroviral infection. Diabetes-associated autoimmunity was evaluated by measurement of several islet cell related autoantibodies. Neutralizing antibodies to different enteroviruses were determined in the case and eight children suffering from aseptic meningitis during a large scale epidemic. Several types of diabetes-associated antibodies were detected post-infection in the adolescent with newly diagnosed type 1 diabetes, including islet cell antibodies (ICA) and tyrosine phosphatase antibodies (IA2A). ICA but not IA2A appeared in the non-diabetic enterovirus-infected subjects. Based on virological studies, type 1 diabetes pathogenesis process could have been triggered by echovirus 30 infections. This study provides the first evidence of an association between echovirus 30 infection with the presence of pancreatic autoimmunity and type 1 diabetes. Our data suggest that echovirus 30 Cuban strain could be considered a potentially diabetogenic enteroviral variant. J. Med. Virol. 76:373-377, 2005. (c) 2005 Wiley-Liss, Inc.

PMID: 15902705 [PubMed - in process]

 

Studies on diabetic polyneuropathy patients with IVIg

Muscle Nerve. 2003 Apr;27(4):465-70.
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Chronic inflammatory demyelinating polyradiculoneuropathy in diabetic patients.

Haq RU, Pendlebury WW, Fries TJ, Tandan R.

Department of Neurology, C 225 Given Building, University of Vermont College of Medicine, Burlington 05405, USA.

This retrospective analysis was undertaken to determine whether a subset of diabetic patients with demyelinating polyneuropathy were similar to patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Ten patients meeting the clinical criteria for idiopathic CIDP were compared to nine patients with diabetes and demyelinating polyneuropathy. The diabetic patients with demyelinating polyneuropathy displayed clinical, electrophysiologic, and histologic features that were similar to those in CIDP patients. All six patients with diabetes and demyelinating polyneuropathy who were treated with immunomodulatory therapy showed a favorable response. Our study highlights the importance of investigating diabetic patients with polyneuropathy in an attempt to identify patients with demyelinating polyneuropathy, because of the likelihood of benefit in these patients from immunomodulatory treatment.

PMID: 12661048 [PubMed - indexed for MEDLINE]

J Neurol. 2002 Jun;249(6):719-22.
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Intravenous immunoglobulin as first treatment in diabetics with concomitant distal symmetric axonal polyneuropathy and CIDP.

Cocito D, Ciaramitaro P, Isoardo G, Barbero P, Migliaretti G, Pipieri A, Proto G, Quadri R, Bergamasco B, Durelli L.

U. O. A. D. U. Neurologia I, Dipartimento di Neuroscienze, Universita di Torino, Via Cherasco 15, 10126 Turin, Italy. dariococito@yahoo.it

The authors investigated the impact of IVIg as first line treatment of diabetic patients suffering from chronic inflammatory demyelinating polyneuropathy (CIDP) concomitant with distal symmetric axonal polyneuropathy. Nine patients with these clinical and electrophysiological features were treated with IVIg (0.4 g/Kg/day for 5 days). Clinical and electrophysiological evaluations were performed before and after treatment. Following IVIg treatment there was no significant improvement in clinical deficit. However, there was a significant and persistent decrease in the Rankin scale score and an improvement in the demyelinating feature on nerve conduction studies. Our findings suggest that IVIg had small but detectable beneficial effects on diabetic patients with CIDP and a high degree of axonal damage.

PMID: 12111305 [PubMed - indexed for MEDLINE]
World J Gastroenterol. 2005 May 21;11(19):2900-5.
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