Diabetologia

, Volume 43, Issue 10, pp 1235–1238

Neonatal Type I diabetes associated with maternal echovirus 6 infection: a case report

  • T. Otonkoski
  • M. Roivainen
  • O. Vaarala
  • B. Dinesen
  • J. A. Leipälä
  • T. Hovi
  • M. Knip
Short communication

DOI: 10.1007/s001250051518

Cite this article as:
Otonkoski, T., Roivainen, M., Vaarala, O. et al. Diabetologia (2000) 43: 1235. doi:10.1007/s001250051518
  • 288 Downloads

Abstract

Aims/hypothesis. Neonatal diabetes mellitus is rare, and it has not been associated with beta-cell autoimmunity. Enteroviral infections during pregnancy have been implicated as a risk factor for the later development of Type I (insulin-dependent) diabetes mellitus. We now report of a baby girl who was born severely growth-retarded with neonatal insulin-deficient diabetes, and look for evidence of intrauterine enteroviral infections and beta-cell targeted autoimmunity.¶Methods. Diabetes-associated autoimmunity was studied by measurement of several types of islet cell reactive autoantibodies. The infant's T-cell responses to insulin and enterovirus antigens were recorded and enterovirus antibodies were measured both from the mother and the child.¶Results. Several types of diabetes-associated autoantibodies were detected postnatally, including insulin autoantibodies, conventional islet cell autoantibodies and glutamic acid decarboxylase antibodies, whereas no autoantibodies were observed in the mother. The infant's T-cells showed reactivity to insulin and purified enterovirus particles. Based on serological studies, the pathogenetic process could have been triggered by an echovirus 6 infection during pregnancy. The patient's diabetes has been permanent, although there were signs of endogenous insulin production for several months. Exocrine pancreatic insufficiency was diagnosed at the age of 1 year.¶Conclusion/interpretation. These observations suggests that enteroviral infections may induce beta-cell autoimmunity even in utero. [Diabetologia (2000) 43: 1235–1238]

Keywords Neonatal diabetes mellitus, autoantibodies, enteroviruses, fetal growth retardation.
Download to read the full article text

Copyright information

© Springer-Verlag Berlin Heidelberg 2000

Authors and Affiliations

  • T. Otonkoski
    • 1
  • M. Roivainen
    • 2
  • O. Vaarala
    • 2
  • B. Dinesen
    • 3
  • J. A. Leipälä
    • 1
  • T. Hovi
    • 2
  • M. Knip
    • 4
  1. 1.Hospital for Children and Adolescents and Haartman Institute, Transplantation Laboratory, University of Helsinki, Helsinki, FinlandFI
  2. 2.National Public Health Institute, Helsinki, FinlandFI
  3. 3.Steno Diabetes Center, Gentofte, DenmarkDK
  4. 4.Medical School, University of Tampere and Department of Paediatrics, Tampere University Hospital, Tampere, FinlandFI