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Toxic shock syndrome associated with newly diagnosed type I diabetes
Author(s) -
Couper J J,
Kallincos N,
Pollard A,
Honeyman M,
Prager P,
Harrison L C,
Rischmueller M
Publication year - 2000
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1046/j.1440-1754.2000.00475.x
Subject(s) - medicine , toxic shock syndrome , superantigen , diabetic ketoacidosis , type 1 diabetes , ketoacidosis , diabetes mellitus , resuscitation , islet , shock (circulatory) , immunology , gastroenterology , staphylococcus aureus , endocrinology , surgery , t cell , immune system , biology , bacteria , genetics
: Studies of two post‐mortem pancreata of children at the onset of type I diabetes have suggested activation and expansion of islet infiltrating T cells by a superantigen. We present the first reported case of a superantigen mediated disease, toxic shock syndrome (TSS), occurring at the diagnosis of type I diabetes. A 12‐year‐old girl presented with TSS and newly diagnosed diabetes with ketoacidosis. At presentation she was unconscious, febrile and hypotensive, with a desquamating erythematous rash and Kussmaul breathing. During resuscitation, her renal impairment, diarrhoea, thrombocytopaenia and ketoacidosis resolved. Vaginal discharge and blood cultures grew Staphylococcus aureus . T cell studies at 2 weeks after diagnosis detected a high level of spontaneous and islet antigen‐specific proliferation with associated interleukin‐10 production compared to human leucocyte antigen DR matched controls.