A Case of Fulminant Type 1 Diabetes Mellitus with Peripheral Neuropathy in a Korean Child
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초록
제 1형 당뇨병은 심각한 췌장 베타 세포의 파괴로 인한 인슐린 결핍 상태로 제 1A형과 제 1B형으로 분류되는데, 제 1A형은 자가 면역성으로, 제 1B형은 특발성으로 발생하는 것으로 알려져 있다. 전격성 당뇨병은 특발성 당뇨병으로 자가 면역성을 보이지 않는 빠르게 진행하는 당뇨병으로 2000년 Imagawa 등에 의해 처음으로 보고되었고, 대부분 일본인들에서 발생하였다. 저자들은 원인이 규명되지 않았으나 14세 여아로 진단 당시 당뇨병 관련 자가 항체를 보이지 않았고, 급격한 경과를 보이고, 췌장 효소의 증가와 고혈당을 보였으며, 당뇨성 말초 신경염을 보였으나 당화 혈색소는 정상 범위를 보인 전격성 당뇨병 소아 환아 1례를 국내에서는 처음으로 경험하였기에 이를 보고하는 바이다.
Abstract
Type 1 diabetes is an insulin-deficient status due to severe destruction of pancreatic beta cells, and is classified into two subtypes, type 1A and type 1B. Type 1A diabetes is autoimmune and type 1B is idiopathic diabetes. Recently fulminant type 1 diabetes has been identified as a new subtype of idiopathic diabetes. It develops rapidly without any evidence of autoimmunity. This subtype of type 1 diabetes was firstly introduced by Imagawa et al. in 2000, and exclusively reported in Japan. Nonetheless, there has been no case reported in Korea till now. Here, we report a case of fulminant type 1 diabetes in 14-year-old girl. She had acute symptoms for short duration, negative islet-related autoantibodies, elevated serum levels of pancreatic exocrine enzymes (amylase, lipase), high blood glucose level and peripheral neuropathy. But HbA1c level was in normal range. Treatment with insulin was successful, acute symptoms were improved and abnormal laboratory data normalized. Her recent HbA1c level showed only a mild elevation.
참고문헌 (9)
- "The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus", Diabetes Care, 26(1), pp.5~20 (2003)
- Imagawa A, "A novel subtype of type 1 diabetes mellitus characterized by a rapid onset and an absence of diabetes-related antibodies", N Engl J Med, 342, pp.301~307 (2000)
- Imagawa A, "Fulminant type 1 diabetes mellitus", Endocr J, 53, pp.577~584 (2006)
- Cho YM, "Fulminant type 1 diabetes in Korea: high prevalence among patients with adult-onset type 1 diabetes", Diabetologia, 50, pp.2276~2279 (2007)
- Murase Y, "Fulminant type 1 diabetes as a high risk group for diabetic microangiopathy-a nationwide 5-year- study in Japan", Diabetologia, 50, pp.531~537 (2007)
- Urakami T, "A subtype of markedly abrupt onset with absolute insulin deficiency in idiopathic type 1 diabetes in Japanese children", Diabetes Care, 25, pp.2353~2354 (2002)
- Imagawa A, "Pathogenesis of fulminant type 1 diabetes", Rev Diabet Stud, 3, pp.169~177 (2006)
- Ikegami H, "Genetics of insulin-dependent diabetes mellitus", Endocr J, 43, pp.605~613 (1996)
- Kawasaki E, "Genetics of fulminant type 1 diabetes", Ann N Y Acad Sci, 1079, pp.24~30 (2006)