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Development of fulminant Type 1 diabetes with thrombocytopenia after influenza vaccination: a case report
Author(s) -
Yasuda H.,
Nagata M.,
Moriyama H.,
Kobayashi H.,
Akisaki T.,
Ueda H.,
Hara K.,
Yokono K.
Publication year - 2012
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2011.03391.x
Subject(s) - medicine , fulminant , vaccination , diabetes mellitus , type 1 diabetes , type 2 diabetes , immunology , autoimmunity , seroconversion , endocrinology , antibody
Diabet. Med. 29, 88–89 (2012) Abstract Background Fulminant Type 1 diabetes was originally reported as idiopathic Type 1 diabetes. Involvement of viral infections in the pathogenesis of fulminant T1D has been suggested, but the development of fulminant Type 1 diabetes after influenza vaccination has not been reported. Case Report We report a case of fulminant Type 1 diabetes with thrombocytopenia following influenza vaccination. A 54‐year‐old man was admitted to hospital with hyperglycaemia and diabetic ketosis. Seven days before admission, he received a seasonal influenza vaccine for the prevention of influenza infection. On admission, blood glucose was 29 mmol/L and HbA1c 40 mmol/mol (5.9%). Fasting and 2‐h C‐peptide immunoreactivity were <0.0333 nmol/L and 0.0999 nmol/L, respectively. Anti‐GAD and anti‐IA‐2 antibodies were negative, so no autoimmunity seemed to participate in the etiology. ELISPOT assay also showed no association with T cell‐mediated autoimmunity. HLA genotypes were consistent with susceptibility to fulminant Type 1 diabetes. After the abrupt onset of diabetes, he showed mild thrombocytopenia, which has been observed for approximately 5 years after diabetes development. Conclusion This is the first description of fulminant Type 1 diabetes after influenza vaccination. Our observation raises the possibility that influenza vaccination might trigger this condition via the TLR7 pathway.