Summary
Thirty-four insulin-dependent diabetics with a coexistent organ-specific autoimmune disease (Graves’ disease, primary myxedema, adrenal insufficiency, generalized vitiligo, primary biliary cirrhosis) were compared to 100 insulin-dependent patients in whom no obvious etiology was detectable. The autoimmune group was characterized by a predominance of females, a family history of autoimmune disease, a later age at onset, better glycemic control, low insulin requirement, persistence of ICA, and greater frequency of HLA B8 but not of B18. However, there was a large overlap between the two groups for all these criteria. In addition, a family history of IDD in first degree relatives and the frequency of serum positive for neutralizing anti-Coxsackie B antibodies were identical in the two groups. These results do not justify the separation of this group of patients as having purely autoimmune diabetes, to the exclusion of other etiological factors, whether genetic or viral.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bastenie P. A.: Diabète et maladies auto-immunitaires — Diabète et Métab.1, 3, 1975.
Betterle C., Peserico A., Bersani G.: Vitiligo and autoimmune polyendocrine deficiencies with autoantibodies to melatonin-producing cells — Arch. Derm.115, 364, 1979.
Bottazzo G. F., Cudworth A. G., Moul D. J., Doniach D., Festenstein M.: Evidence for a primary autoimmune type of diabetes mellitus — Brit. med. J.ii, 1253, 1978.
Bottazzo G. F., Florin-Christensen A., Doniach D.: Islet-cell antibodies in diabetes mellitus with autoimmune polyendocrine deficiencies — Lancetii, 1279, 1974.
Bottazzo G. F., Mann J. I., Thorogood M., Baum J. D., Doniach D.: Autoimmunity in juvenile diabetics and their families — Brit. med. J.ii, 165, 1978.
Cahill G. F. Jr., McDevitt H. O.: Insulin-dependent diabetes mellitus: the initial lesion — New Engl. J. Med.304, 1454, 1981.
Cathelineau G., Cathelineau L., Hors J., Schmid M., Dausset J.: Les groupes HLA dans le diabète à début précoce — Nouv. Presse méd.5, 586, 1976.
Dawber R. P. R.: Vitiligo in maturity-onset diabetes mellitus — Brit. J. Derm.80, 275, 1968.
Eisenbarth G. S., Wilson P. W., Ward F., Buckley D., Lebovitz M.: The polyglandular failure syndrome: disease inheritance, HLA type and immune function. Studies in patients and families — Ann. intern Med.91, 528, 1979.
Elmofty A. M., Elmofty M.: Vitiligo, a symptom — Int. J. Derm.5, 237, 1980.
Feely J., Isles T. E.: Screening for thyroid dysfunction in diabetics — Brit. med. J.i, 1678, 1979.
Gamble D. R., Kinsley M. L., Fitzgerald M. G., Bolton R., Taylor K. W.: Viral antibodies in diabetes mellitus — Brit. med. J.iii, 627, 1969.
Gorsush A. N., Dean B. M., Bottazzo G. F., Lister J., Cudworth A. G.: Evidence that type I diabetes and thyrogastric autoimmunity have different genetic determinants — Brit. med. J.280, 145, 1980.
Gray R. S., Clarke B. F.: Primary autoimmune diabetes mellitus — Brit. med. J.ii, 1715, 1978.
Gray R. S., Herd R., Clarke B. F.: The clinical features of diabetes with coexisting autoimmune thyroid disease — Diabetologia20, 602, 1981.
Harsoulis P., Kanakouki-Tsakalidis F., Vyzantiadis A., Minas A., Cassinos O.: Autoimmunity and vitiligo — Arch. Derm.14, 1554, 1978.
Hertz K. C., Gazze L. A., Kirkpatrick C. M., Katz S. I.: Autoimmune vitiligo: detection of antibodies to melanin-producing cells — New Engl. J. Med.297, 634, 1977.
Howanitz N., Norlund J. L., Lerner A. B., Bystryn J. C.: Antibodies to melanocytes — Arch. Derm.17, 705, 1981.
Irvine W. J.: Classification of idiopathic diabetes — Lanceti, 638, 1971.
Irvine W. J. (Ed.): Immunology of diabetes, Teviot Scientific Publications, Edinburgh, 1980.
Irvine W. J., McCallum C. J., Gray R. S., Campbell C. J., Duncan L. J. P., Farquhar J. W., Vaughan H., Morris P. O.: Pancreatic islet-cell antibodies in diabetes mellitus correlated with the duration and type of diabetes, coexistent autoimmune disease and HLA type Diabetes26, 138, 1977.
Macaron C., Winter R. J., Traisman M. S., Kahen B. D., Lasser A., Green D. C.: Vitiligo and juvenile diabetes mellitus — Arch. Derm.113, 1515, 1977.
Madsbad S., Bottazzo G. F., Cudworth A. G., Dean B., Faber O. K., Binder C.: Islet-cell antibodies and beta-cell function in insulin dependent diabetics — Diabetologia18, 45, 1980.
Nelson P. G., Pyke D. A., Gamble D. R.: Viruses and aetiology of diabetes: a study in identical twins — Brit. med. J.iv, 249, 1975.
Ortonne J. P., Perrot H., Thivolet J.: Étude clinique et statistique d’une population de 100 vitiligos. II. Lésions associées — Sem. Hôp. Paris52, 679, 1976.
Peserico A., Rigon F., Giampietro A.: Vitiligo and polyglandular autoimmune disease with autoantibodies to melanin-producing cells. A new syndrome? — Arch. Derm.117, 751, 1981.
Riley W. J., MacLaren N. K., Neufeld M.: Adrenal autoantibodies and Addison’s disease in insulin dependent diabetes mellitus — J. Pediat.97, 191, 1980.
Riley J. W., MacLaren N. K., Rand K., Bejar R.: Inherited autoimmunity versus Coxsackie B4 in insulin dependent diabetes — Diabetes29 (Suppl.), 211, 1980; abstract.
Rossi D., La Marca A. T., De Micco Ph., Codaccioni J. L.: Étude de l’étiologie virale du diabète insulino-dépendant par la séroneutralisation aux virus coxsackie — Diabète et Métab.6, 302, 1980; abstract.
Seignalet J., Mirouze J., Jaffiol C., Selam J. L., Lapinski H.: HLA in Graves’ disease and in diabetes mellitus insulin dependent — Tissue Ageing6, 272, 1975.
Vague Ph., Vialettes B., Prince M. A., De Micco Ph.: Coxsackie B viruses and autoimmune diabetes — New Engl. J. Med.305, 1157, 1981.
Vague Ph., Vovan L., Vialettes B., Boustieres C., Serin C.: Concentration sanguine en hémoglobine glycosyleé (A1c). Indice du contrôle du diabète dans le mois précedant — Nouv. Presse méd.8, 491, 1979.
Wilson P. W., Buckley C. E. III., Eisenbarth G. S.: Disordered immune function in patients with polyglandular failure — J. clin. Endocr.52, 284, 1981.
Yoon J. W., Austin M., Onodera T., Notkins A. L.: Virus-induced-diabetes mellitus. Isolation of a virus from the pancreas of a child with diabetic ketoacidosis — New Engl. J. Med.300, 1173, 1979.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Prince, M.A., Vialettes, B., Zevaco-Mattei, C. et al. Clinical characteristics and etiological markers in insulin-dependent diabetes associated with an organ-specific autoimmune disease. Acta diabet. lat 20, 221–229 (1983). https://doi.org/10.1007/BF02581266
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF02581266