Two Cases of Fulminant Type 1 Diabetes Mellitus Associated with Vogt-Koyanagi-Harada Syndrome

Abstract

We experienced two cases of fulminant type 1 diabetes mellitus associated with Vogt-Koyanagi-Harada syndrome. The first case involved a woman who was diagnosed with Hashimoto's thyroiditis at 33 years of age and Vogt-Koyanagi-Harada syndrome at 36 years of age. Her poor eyesight recovered following the administration of steroid therapy for one year. At 44 years of age, she developed diarrhea in addition to abdominal pain, nausea, vomiting and symptoms of diabetes, with weight loss of 5 kg over one week. She was subsequently diagnosed with fulminant type 1 diabetes mellitus due to the abrupt onset of symptoms as well as a plasma glucose level of 756 mg/dl, an HbA1c of level 7.3 % (NGSP) and depletion of endogenous insulin secretion. The second case involved a man who visited a clinic with common cold symptoms and was diagnosed with fulminant type 1 diabetes mellitus by chance due to a plasma glucose level of approximately 600 mg/dl and an HbA1c level of 6.0 % at 34 years of age. At 39 years of age, he developed poor vision. The patient was ultimately diagnosed with Vogt-Koyanagi-Harada syndrome due to retinal detachment and iritis. His eyesight recovered under steroid pulse therapy, and no other symptoms specific to Vogt-Koyanagi-Harada syndrome have since been observed.