Co-existing of Neuromyelitis Optica and Fulminant Type 1 Diabetes

Takanobu Saheki; Hitomi Imachi; Tomohiro Ibata; Kensuke Fukunaga; Yuki Yoshioka; Toshihiro Kobayashi; Seisuke Sato; Kazuko Mizumoto; Takuo Yoshimoto; Jingya Lyu; Tao Dong; Koji Murao

doi:10.2169/internalmedicine.2353-18

CASE REPORTS

Co-existing of Neuromyelitis Optica and Fulminant Type 1 Diabetes

Takanobu Saheki, Hitomi Imachi, Tomohiro Ibata, Kensuke Fukunaga, Yuki Yoshioka, Toshihiro Kobayashi, Seisuke Sato, Kazuko Mizumoto, Takuo Yoshimoto, Jingya Lyu, Tao Dong, Koji Murao

Author information

Takanobu Saheki
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Hitomi Imachi
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Tomohiro Ibata
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Kensuke Fukunaga
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Yuki Yoshioka
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Toshihiro Kobayashi
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Seisuke Sato
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Kazuko Mizumoto
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Takuo Yoshimoto
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Jingya Lyu
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Tao Dong
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Koji Murao
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan

Keywords: type 1 diabetes mellitus, neuromyelitis optica, diabetic ketoacidosis

JOURNAL OPEN ACCESS

2019 Volume 58 Issue 13 Pages 1913-1916

DOI https://doi.org/10.2169/internalmedicine.2353-18

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Abstract

The patient was a 71-year-old woman with aquaporin-4-antibody positive neuromyelitis optica (NMO), with no history of diabetes. On admission, although she showed an extremely elevated plasma glucose level (1,080 mg/dL), her hemoglobin A1c level was low (7.1%), which indicated the rapid progression of diabetes. She also showed ketoacidosis and had a human leukocyte antigen haplotype, DRB1*09:01-DQB1*03:03 associated with Fulminant type 1 diabetes (FT1D). Based on these results, the patient was diagnosed with FT1D. We herein describe the first reported case of a patient with FT1D with NMO, which raises the possibility that T-cell-mediated autoimmunity is involved in the pathogenesis of both FT1D and NMO.

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