Open AccessEvaluation of cellular and humoral autoimmunity before the development of type 1 diabetes in a patient with idiopathic CD 4 lymphocytopenia
Author(s) -
Maruyama Koji,
Chujo Daisuke,
Watanabe Koji,
Kawabe Akitsu,
Sugiyama Takehiro,
Ohsugi Mitsuru,
Tanabe Akiyo,
Ueki Kohjiro,
Kajio Hiroshi
Publication year - 2019
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.12997
Subject(s) - medicine , autoantibody , type 1 diabetes , lymphocytopenia , autoimmunity , immunology , diabetes mellitus , type 2 diabetes , endocrinology , islet , antibody , lymphocyte
A 64‐year‐old woman developed type 1 diabetes 23 years after the diagnosis of idiopathic CD 4 lymphocytopenia. To investigate the etiological interaction between idiopathic CD 4 lymphocytopenia and type 1 diabetes, we carried out a longitudinal analysis related to islet‐specific autoimmunity. Anti‐glutamic acid decarboxylase antibody had been already weakly positive for at least 16 years and started rising at 6 months before the onset of type 1 diabetes. The seroconversion of anti‐insulinoma‐associated antigen‐2 antibody and insulin autoantibody occurred at the time of onset. The ratio of CD 8/ CD 4 had been gradually increasing for 8 years before type 1 diabetes onset. Notably, islet‐specific glucose‐6‐phosphatase catalytic subunit‐related protein‐reactive CD 8 + T cells were detected at type 1 diabetes onset, and the frequency was higher than that in 15 non‐diabetic controls (6.75% vs 0.49 ± 0.78%, mean ± SD ). The present type 1 diabetes patient, presented with idiopathic CD 4 lymphocytopenia and showed an elevated number of CD 8 + T cells, including the islet antigen‐specific CD 8 + T cells that might contribute to autoimmune destruction of pancreatic β‐cells.