Kimura N, Fujiya H, Yamaguchi K, Takahashi T, Nagura H
Department of Pathology, Tohoku University School of Medicine, Sendai, Japan.
Arch Pathol Lab Med. 1994 Jan;118(1):84-8.
We report an autopsy case of acute-onset insulin-dependent diabetes mellitus, type I, that occurred in an adult. The patient died 3 days after the clinical onset of diabetes. Hyperglycemia, ketonuria, and hyperamylasemia were observed at admission. The pathologic examination of the pancreas showed a markedly decreased number of islets, and residual islets were small and shrunken. Diffuse inflammatory cell infiltrates, which were found in islets and also in acini, were mainly T lymphocytes. Shrunken islets were composed of insulin cells, glucagon cells, somatostatin cells, and pancreatic polypeptide cells. A decreased number of zymogen granules in acini were prominent [corrected]. This case suggested that pan-pancreatitis, destroying whole islets and acini, can initiate insulin-dependent diabetes mellitus.
我们报告一例成年急性起病的Ⅰ型胰岛素依赖型糖尿病尸检病例。患者在糖尿病临床发病后3天死亡。入院时观察到高血糖、酮尿症和高淀粉酶血症。胰腺病理检查显示胰岛数量明显减少，残余胰岛小且萎缩。在胰岛和腺泡中均发现弥漫性炎性细胞浸润，主要为T淋巴细胞。萎缩的胰岛由胰岛素细胞、胰高血糖素细胞、生长抑素细胞和胰多肽细胞组成。腺泡中酶原颗粒数量减少显著[校正后]。该病例提示，全胰腺炎破坏整个胰岛和腺泡可引发胰岛素依赖型糖尿病。
