De Block C E, De Leeuw I H, Pelckmans P A, Michielsen P P, Bogers J J, Van Marck E A, Van Gaal L F
Department of Endocrinology-Diabetology, Faculty of Medicine, University of Antwerp (UA), University Hospital Antwerp, Edegem, Belgium.
J Diabetes Complications. 2000 Mar-Apr;14(2):116-20. doi: 10.1016/s1056-8727(00)00059-3.
The history of a 45-year-old male type 1 diabetic patient is presented. At the age of 29 years, he was diagnosed to have an autoimmune hepatitis with incipient liver cirrhosis. Five years later, a successful liver/pancreas transplantation was performed. Eighteen months later, however, pancreatic insufficiency occurred due to thrombosis of the pancreatic graft. Besides these conditions, iron deficiency, pernicious anemia, and autoimmune gastritis were also diagnosed. Serum parietal cell antibodies (PCA) and intrinsic factor antibodies (AIF) were positive. At 45, this patient was found to have a gastric carcinoid tumor. The clinical importance of PCA is discussed with regard to chronic atrophic gastritis and pernicious anemia, which both predispose toward gastric carcinoid tumors. Autoimmune type 1 diabetic patients who have a high prevalence of PCA should be screened for gastric autoimmune manifestations and tumors, as the history of this patient illustrates.
本文介绍了一名45岁1型糖尿病男性患者的病史。29岁时，他被诊断为自身免疫性肝炎伴早期肝硬化。五年后，成功进行了肝/胰移植。然而，18个月后，由于胰移植血栓形成出现了胰腺功能不全。除此之外，还诊断出缺铁、恶性贫血和自身免疫性胃炎。血清壁细胞抗体（PCA）和内因子抗体（AIF）呈阳性。45岁时，该患者被发现患有胃类癌肿瘤。本文讨论了PCA在慢性萎缩性胃炎和恶性贫血中的临床重要性，这两种疾病都易患胃类癌肿瘤。正如该患者的病史所示，PCA患病率高的自身免疫性1型糖尿病患者应筛查胃部自身免疫表现和肿瘤。
