Pancreatic Inflammation Captured by Imaging Technology at the Onset of Fulminant Type 1 Diabetes

Type 1 diabetes mellitus is classified as autoimmune (type 1A) or idiopathic (type 1B) (1). Fulminant type 1 diabetes is classified as type 1B, characterized by acute onset of diabetic ketoacidosis soon after the development of typical diabetes symptoms, near-normal HbA1c level at onset, negative serum GAD antibody, and markedly acute progression of insulin deficiency (2). Infiltration of macrophage and T cells into the islets of Langerhans and complete destruction of pancreatic β-cells are characteristic. In this report, we detected pancreatic inflammation in a patient with fulminant type 1 diabetes by both dynamic computed tomography (CT) and MRI, which have been focused on as noninvasive imaging technologies for the pancreas (3).A 36-year-old Japanese male was referred to our hospital because of diabetic ketoacidosis. He suffered from left abdominal pain, sore throat, and high fever …