Takeuchi K, Hori Y, Hayakawa T, Hashimoto H, Atsumi T, Hirose K, Sakai K, Nishikawa T, Miwa A, Takashiro Y, Suzuki T
Department of Internal Medicine, Kushiro Red Cross Hospital, Hokkaido.
Ryumachi. 1996 Oct;36(5):769-74.
Insulin-dependent diabetes mellitus (IDDM) is thought to result from the autoimmune destruction of the insulin-dependent beta cells of the pancreas. Sjögren's syndrome is also an autoimmune disease characterized by the destruction of the lacrimal and salivary glands that leads to keratoconjunctivitis sicca and xerostomia. But it is a very rare case that a patient with Sjögren's syndrome developed IDDM. We present a case of a 65-year old woman with Sjögren's syndrome who developed diabetic ketoacidosis due to IDDM. Recent studies have revealed that there was molecular mimicry between glutamic acid decarboxylase (GAD) and coxsackievirus. Furthermore, some reports have shown that sialadenitis was represented in IDDM model mice. This case shows the possibility that a causal relationship between IDDM and Sjögren's syndrome may exist.
胰岛素依赖型糖尿病（IDDM）被认为是由胰腺中胰岛素依赖的β细胞发生自身免疫性破坏所致。干燥综合征也是一种自身免疫性疾病，其特征是泪腺和唾液腺遭到破坏，进而导致干燥性角结膜炎和口腔干燥。但干燥综合征患者并发IDDM的情况极为罕见。我们报告一例65岁患有干燥综合征的女性患者，该患者因IDDM而发生糖尿病酮症酸中毒。最近的研究表明，谷氨酸脱羧酶（GAD）与柯萨奇病毒之间存在分子模拟。此外，一些报告显示在IDDM模型小鼠中存在涎腺炎。该病例表明IDDM与干燥综合征之间可能存在因果关系。
