Two Cases of Type 1 Diabetes Mellitus Accompanied by Graves' Disease

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  • Otoda Toshiki
    Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science
  • Sakurai Masaru
    Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science
  • Ota Tsuguhito
    Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science
  • Kurita Seiichiro
    Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science
  • Misu Hirofumi
    Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science
  • Shimizu Akiko
    Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science
  • Ando Hitoshi
    Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science
  • Kaneko Shuichi
    Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science
  • Takamura Toshinari
    Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science

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Other Title
  • 1型糖尿病とバセドウ病を同時期に診断しえた多腺性自己免疫症候群の2例
  • 症例報告 1型糖尿病とバセドウ病を同時期に診断しえた多腺性自己免疫症候群の2例
  • ショウレイ ホウコク 1ガタ トウニョウビョウ ト バセドウビョウ オ ドウ ジキ ニ シンダン シエタ タセンセイ ジコ メンエキ ショウコウグン ノ 2レイ

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Abstract

Case 1: A 31-year-old woman admitted after reporting thirst for a month was found in laboratory data to have fasting plasma glucose of 219 mg/dl, HbA1c of 8.8%, positive anti-GAD antibody, plasma TSH below 0.01 μU/ml, normal free triiodothyronine and thyroxine, and positive TSH receptor antibody.<br>Case 2: A 51-year-old woman with diabetes mellitus treated with oral hypoglycemic agent for 2 months and admitted for glycemic control was found in laboratory data to have HbA1c of 9.2%, urinary C-peptide secretion of 12 μg/day, positeve anti-GAD antibody, plasma TSH below 0.01 μU/ml, high free triiodothyronine and thyroxine, and positive thyroid stimulating antibody.<br>Both were diagnosed as having simultaneous type 1 diabetes mellitus and Graves' disease, i.e., type III polyglandular autoimmune (PGA) syndrome.<br>HLA examination showed that case 1 had HLA B61, DR9, and DRB1*0901-DQB1*0303 associated with type 1 diabetes. Case 2 had HLA DQB1*0601 and DQB1*0401, the former sensitive and the second a resistant allele in type1 diabetes. The difference in HLA antigen may influence the difference in incidence.

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