+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

A case of insulin-dependent diabetes mellitus with CD8+ T-lymphocyte-predominant insulitis in a pancreatic biopsy specimen

A case of insulin-dependent diabetes mellitus with CD8+ T-lymphocyte-predominant insulitis in a pancreatic biopsy specimen

Journal of the Japan Diabetes Society 36(11): 875-880

A 22-year-old female developed diabetic ketoacidosis and was diagnosed as having IDDM with positive tests for islet cell antibodies (ICA) and HLA-DR4/9. The patient also had Graves' disease. Four months after the onset of IDDM, we performed laparoscopic biopsy of the pancreas to evaluate immunohistological abnormalities in the islets. Immunohistochemical analysis of the biopsy specimens revealed a decrease in the number of beta-cells, preservation of alpha and delta-cells, and mononuclear cell infiltration of the islets (insulitis). The infiltrating cells consisted of T-lymphocytes, B -lymphocytes and macrophages, and the most predominant subpopulation was CD8+ T-lymphocytes. As regards T-cell receptors, both alpha-beta- and gamma-delta-T-lymphocytes were observed in the islets. The biopsy specimen also showed hyperexpression of MHC class I antigens in the islet cells and of MHC class I and II antigens in the endothelial cells. These findings suggest that CD8+ T-lymphocytes, which predominantly infiltrated the islets, recognize beta-cell-autoantigens in conjunction with the hyperexpressed self-MHC-class I antigens, and may then have mediated beta-cell destruction. The positive ICA test and association with Graves' disease support the involvement of immunological abnormalities in the destruction of beta-cells in this case.

(PDF emailed within 1 workday: $29.90)

Accession: 008025104

Download citation: RISBibTeXText

Related references

A case of insulin dependent diabetes mellitus with insulitis. Journal of the Japan Diabetes Society 34(8): 725-730, 1991

Autoimmune aspects of insulin-dependent diabetes mellitus. Insulitis and pancreatic beta-cell destruction. Problemy Endokrinologii 32(3): 81-87, 1986

Granulomatous Insulitis as a Cause of Acute-Onset Insulin-Dependent Diabetes Mellitus in a Patient With a Pancreatic Endocrine Carcinoma. International Journal of Surgical Pathology 24(7): 648-652, 2017

Immune insulitis and manifest diabetes mellitus. Studies on the course of immune insulitis and the induction of diabetes mellitus in rabbits immunized with insulin. Virchows Archiv. A, Pathological Anatomy and Histology 364(4): 333-346, 1974

The pancreas in recent onset type 1 insulin dependent diabetes mellitus insulin content in islets insulitis and associated changes in the exocrine acinar tissue. Diabetologia 26(2): 456-461, 1984

Imaging of β-cell mass and insulitis in insulin-dependent (Type 1) diabetes mellitus. Endocrine Reviews 33(6): 892-919, 2013

Imaging of beta-Cell Mass and Insulitis in Insulin-Dependent Type 1 Diabetes Mellitus. 2013

Immunohistochemical demonstration of sparse mononuclear cell infiltration into islets of pancreatic biopsy specimens in a patient with insulin dependent diabetes mellitus. Journal of the Japan Diabetes Society 34(9): 809-815, 1991

Insulitis and mechanisms of disease resistance: Studies in an animal model of insulin dependent diabetes mellitus. Journal of Molecular Medicine 77(1): 57-61, 1999

Insulitis in type 1 (insulin-dependent) diabetes mellitus in man--macrophages, lymphocytes, and interferon-gamma containing cells. Journal of Pathology 165(2): 97-103, 1991

The development of insulin dependent diabetes mellitus with insulitis during a period of remission of allergic granulomatous angitis. Journal of the Japan Diabetes Society 34(8): 731-737, 1991

A genetic study of epistasis between genotypes responsible for juvenile onset type diabetes mellitus insulin dependent diabetes mellitus and hla 2. the assumption of dominance of insulin dependent diabetes mellitus. Journal of the Japan Diabetes Society 27(11): 1147-1156, 1984

Local production of human IL-6 promotes insulitis but retards the onset of insulin-dependent diabetes mellitus in non-obese diabetic mice. International Immunology 6(12): 1829-1837, 1994

IL-4 prevents insulitis and insulin-dependent diabetes mellitus in nonobese diabetic mice by potentiation of regulatory T helper-2 cell function. Journal of Immunology 159(10): 4686-4692, 1997

Increased circulating leptin concentrations in insulin-resistant first-degree relatives of patients with non-insulin-dependent diabetes mellitus: relationship to body composition and insulin sensitivity but not to family history of non-insulin-dependent diabetes mellitus. European Journal of Endocrinology 136(2): 173-179, 1997