Diabetes Mellitus Following Mumps in a Patient with Laurence-Moon-Biedl Syndrome

Abstract

A 15 year-old female patient was admitted to the hospital on February 19, 1974 because of glycosuria associated with general malaise thirst, polyuria and visual impairment.
Her childhood physical and mental development were retarded, although she was born full term without complication. At the age of 6, she developed obesity. At the age of 10, she was transferred into a special class due to retarded intelligence. She also started to complain of visual impairment. She received urinalysis by chance at thet age of 11, resulting in negative glycosuria. Her menarche was at the age of 14, but subsequent menstruation has been quite irregular.
On January 28, 1974 she developed swelling and tenderness in the right cheek associated with a fever of 38°C and a diagnosis of mumps was made. During the course of convalescence urinalysis showed glycosuria. In mid-February, she noted thirst and polyuria associated with general malaise and entered the hospital on February 19, 1974.
On examination her height was 142cm and body weight was 48.5kg. Intelligence was retarded and I. Q. was 37. Visual acuity was impaired and fundoscopic examination revealed degeneratio retinae pigmentosa bilaterally. Secondary sex charactaristics including mammillary glands, axillary and pubic hair were poorly developed and a hypoplasic uterus was observed. A 50g GTT showed high glucose levels which was indicative of diabetic pattern. Serum IRI during the 50g GTT were somewhat low and delayed. Mumps Hi titre was positve.
The patient was placed on a diet and received oral administration of tolbutamide, which resulted in a controlled blood glucose level and improvement of thirst and general malaise.
These findings indicated development of diabetes mellitus in a patient with Laurence-Moon-Biedl syndrome. It is strongly suggested that the onset of diabetes mellitus in this patient might be a consequence of the preceding mumps infection.