J Korean Endocr Soc.  2009 Jun;24(2):116-120. 10.3803/jkes.2009.24.2.116.

A Case of Fulminant Type 1 Diabetes Mellitus Complicated with Ischemic Ileitis

• Oh SW
• Park JR
• Lee YJ
• Kim HY
• Seo JA
• Kim NH
• Choi KM
• Baik SH
• Choi DS
• Kim SG

• KMID: 1468506
• DOI: http://doi.org/10.3803/jkes.2009.24.2.116

Abstract

Fulminant type 1 diabetes is characterized by diabetes with an abrupt onset, severe metabolic acidosis at diagnosis, a low HbA1c level and negativity for islet cell-related autoantibodies, and this illness has been classified as type 1B diabetes by the WHO. The prevalence of this disease is higher in Japan than any other country and recently, there have been an increasing number of such case reports in Korea. Genetic factors and environmental factors such as virus infection and an immune mechanism have been suggested as the mechanism of the pathophysiology, but this remains to be clarified.

Keyword

fulminant; ischemic ileitis; type 1 diabetes mellitus

MeSH Terms

Acidosis
Autoantibodies
Diabetes Mellitus, Type 1
Ileitis
Japan
Korea
Prevalence
Viruses
Autoantibodies

Figure

• 

  Fig. 1 A Non-enhanced abdominal CT. It showed the air in portal vein of segment 2 and 4 of liver C (A, B), the multiple free air in external surface of the serosa (C) and the edematous and circumferential wall thickening in small bowel (D).

• 

  Fig. 2 The gross specimen of a resected segment of small bowel measuring 56 cm in length. The external surface shows a focal whitish gray ischemic area, measuring 8 × 2 cm across, covered with yellowish pus-like material.

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  Fig. 3 The pathology specimen of a resected segment of small bowel. an acute inflammation with extensive submucosal edema and ischemic change with thrombi (H&E stain, ×40 (A), ×200 (B)).

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