Abstract
A 57-year-old man had been admitted to our hospital at 55 years of age complaining of thirst, excessive drinking, polyuria and weight loss. He had been previously diagnosed with impaired glucose tolerance in his late 30's and psoriasis at 47 years of age. The plasma glucose level was found to have exceeded 600 mg/dl at approximately 48 years of age; however, he did not receive a thorough examination at that time. The laboratory data obtained on admission showed a plasma glucose level of 623 mg/dl, HbA1c level of 16.6 % and relatively high serum ketone body levels, resulting in a diagnosis of diabetic ketosis. After conducting a thorough examination, he was diagnosed with type 2 diabetes mellitus. Autoimmune pancreatitis was detected during the course of treatment for type 2 diabetes mellitus. One and a half years later, the patient also developed hydronephrosis due to retroperitoneal fibrosis, and steroid therapy was initiated. While the treatment improved the retroperitoneal fibrosis, hydronephrosis and autoimmune pancreatitis, the diabetes mellitus remained unchanged. Therefore, steroid therapy for autoimmune pancreatitis was apparently ineffective in treating diabetes mellitus in this patient, although the effect could not be estimated due to the patient's disordered lifestyle.
