Diabetology International

, Volume 3, Issue 1, pp 50–53 | Cite as

A case of long-standing autoimmune type 1 diabetes with common variable immunodeficiency

  • Masaya Yamaoka
  • Tetsuhiro Kitamura
  • Hiroaki Moriyama
  • Yoshihito Shima
  • Fumitaka Haseda
  • Kohei Okita
  • Yukako Sakaguchi
  • Hiromi Iwahashi
  • Toshiaki Hanafusa
  • Tohru Funahashi
  • Masao Nagata
  • Michio Otsuki
  • Akihisa Imagawa
  • Iichiro Shimomura
Case report
  • 95 Downloads

Abstract

Several lines of evidence have suggested that pancreatic β-cell destruction is caused by inflammatory cellular responses mediated by T lymphocytes in individuals with type 1A diabetes. B lymphocytes, which play an important role in the production of autoantibodies to β-cell antigens such as insulin, glutamic acid decarboxylase (GAD) or insulinoma associated antigen 2 (IA-2) in type 1A diabetes, are also known as professional antigen-presenting cells and T-lymphocyte activators. Here, we report a case of long-standing autoimmune type 1 diabetes with common variable immunodeficiency, which is known as a functional deficiency of B lymphocytes. A 51-year-old man was admitted to our hospital because of hyperglycemia. He had suffered from frequent bacterial infections from early childhood. At 16 years old, he was diagnosed with common variable immunodeficiency. At age 27, he experienced sudden-onset diabetic ketosis and was diagnosed with type 1 diabetes. Enzyme-linked immunospot (ELISPOT) assay recently revealed that interferon-γ-producing T lymphocytes but not interleukin 4-producing T lymphocytes, which react with GAD and insulin B1-18, were present at increased levels in his peripheral blood at 51 years old. This case represents the longest reported interval between onset of type 1 diabetes and confirmation of cell-mediated autoimmunity against pancreatic β-cells in a patient with common variable immunodeficiency.

Keywords

IDDM CVID ELISPOT GAD IA-2 

Notes

Acknowledgments

This study was supported in part by a Grant-in-Aid for Research on Intractable Diseases from the Japanese Ministry of Health, Labour and Welfare. The authors have no relevant conflict of interest to disclose.

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Copyright information

© The Japan Diabetes Society 2011

Authors and Affiliations

  • Masaya Yamaoka
    • 1
  • Tetsuhiro Kitamura
    • 1
  • Hiroaki Moriyama
    • 2
  • Yoshihito Shima
    • 3
  • Fumitaka Haseda
    • 4
  • Kohei Okita
    • 1
  • Yukako Sakaguchi
    • 1
  • Hiromi Iwahashi
    • 1
  • Toshiaki Hanafusa
    • 4
  • Tohru Funahashi
    • 1
  • Masao Nagata
    • 2
  • Michio Otsuki
    • 1
  • Akihisa Imagawa
    • 1
  • Iichiro Shimomura
    • 1
  1. 1.Department of Metabolic Medicine, Graduate School of MedicineOsaka UniversitySuitaJapan
  2. 2.Department of Internal and Geriatric MedicineKobe University Graduate School of MedicineKobeJapan
  3. 3.Department of Respiratory Medicine and Allergy and Rheumatic Disease, Graduate School of MedicineOsaka UniversitySuitaJapan
  4. 4.Department of Internal Medicine (I)Osaka Medical CollegeTakatsukiJapan

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