Yamazaki Masanori, Sato Ai, Takeda Teiji, Komatsu Mitsuhisa
Department of Aging Medicine and Geriatrics, Division of Medicine, Institute on Aging and Adaptation, Shinshu University Graduate School, Matsumoto.
Intern Med. 2010;49(5):403-7. doi: 10.2169/internalmedicine.49.2656. Epub 2010 Mar 1.
We report two cases of type 1 diabetes mellitus (T1DM) which developed after interferon (IFN) therapy for chronic hepatitis C. The patients had experienced abrupt hyperglycemia with positive anti-glutamic acid decarboxylase antibodies, resulting in initiation of insulin therapy. In one case, insulin therapy could be discontinued because endogenous insulin secretion was preserved at the onset and pancreatic beta cell function was recovered thereafter. In the other case with Hashimoto's thyroiditis and Sjögren's syndrome, continuation of insulin therapy was necessary because blood glucose levels were unstably controlled. Lasting autoimmunity superior to immunosuppressive mechanism may be associated with distinct clinical courses in these cases.
我们报告了两例1型糖尿病（T1DM），均在干扰素（IFN）治疗慢性丙型肝炎后发生。患者出现急性高血糖，谷氨酸脱羧酶抗体阳性，从而开始胰岛素治疗。其中一例，由于发病时内源性胰岛素分泌得以保留且胰腺β细胞功能随后恢复，胰岛素治疗可以停用。另一例患有桥本甲状腺炎和干燥综合征，由于血糖水平控制不稳定，胰岛素治疗仍有必要继续。在这些病例中，持久的自身免疫性强于免疫抑制机制，可能与不同的临床病程有关。
