1995 Volume 38 Issue 5 Pages 395-400
A 49-year-old woman developed insulin-dependent diabetes mellitus (IDDM) during interferon-α(IFN-α) therapy for chronic myelogenous leukemia (CML). CML was diagnosed in 1985. She had been receiving hydroxyurea and ubenimex since 1985, but in June 1991, her CML became exacerbated and recombinant IFN-α2b (Schering) was started at 6 MU twice weekly. During treatment her white blood cell count was controlled within normal range, but the Philadelphia chromosome persisted. In July, 1993, the patient experienced the sudden onset of thirst, polyuria, polydipsia and general malaise. She was hyperglycemic, had high HbA1c levels and ketonemia with low serum and urinary C-peptide. Islet-cell antibody (ICA) was detected, but islet cell surface antibody (ICSA) was not. HLA-typing yielded: DR4/DR9, DRB10405, 0901, DQA10301 and DQB10401, 0303. The thyroid microsome antibody titer was above normal, and thyroid function test results were just below the normal range. This patient may have had genetic susceptibility to IDDM and developed this disease during IFN-α therapy. Treatment may have elicited a pancreatic autoimmune process, inducing pancreatic, β-cell destrution.
