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新冠病毒感染后新发自身免疫性 1 型糖尿病病例报告。

A Case of New-onset Autoimmune Type-1 Diabetes Mellitus Following COVID-19 Infection.

机构信息

Department of Endocrinology and Metabolism, Faculty of Medicine, Başkent University, Ankara, Turkey.

出版信息

Endocr Metab Immune Disord Drug Targets. 2023;23(11):1455-1457. doi: 10.2174/1871530323666230418092121.

Abstract

BACKGROUND

After COVID-19 infection, various mechanisms may initiate an increased risk of developing DM. This study presented a newly developed autoimmune Type 1 DM (T1DM) case in an adult patient after a SARS-CoV-2 infection.

CASE PRESENTATION

A 48-year-old male patient presented with complaints of weight loss and blurred vision. His blood sugar and HbA1c were measured as 557 mg/dl and 12.6%, respectively. His medical records showed no known diagnosis of DM. He had a SARS-CoV-2 infection 4 weeks ago. Then, we diagnosed DM and started basal-bolus insulin therapy. C-peptides and autoantibodies were requested from the patient to explore the etiology of diabetes. Glutamic acid decarboxylase (GAD) antibody was > 2000 U/mL (ref: 0-10); therefore, the patient was accepted as having autoimmune T1DM. New-onset DM cases triggered by COVID-19 have increasingly been reported recently. SARS-CoV-2 virus, using the ACE2 receptor in the pancreas, can enter beta cells and causes damage to these islets and impaired insulin secretion, leading to acute diabetes mellitus. In addition, the abnormal immunity elicited by SARS-CoV-2 can also induce autoimmune destruction of pancreatic islet cells.

CONCLUSION

T1DM may be an uncommon but possible complication due to the COVID-19 virus among genetically predisposed individuals. Overall, the case highlights the importance of preventive measures, such as vaccination, to protect against COVID-19 and its complications.

摘要

背景

COVID-19 感染后,多种机制可能会增加发生 DM 的风险。本研究报告了一例新发生的成人 COVID-19 感染后自身免疫性 1 型糖尿病(T1DM)病例。

病例介绍

一名 48 岁男性患者因体重减轻和视力模糊就诊。他的血糖和 HbA1c 分别为 557mg/dl 和 12.6%。其病历中无已知的 DM 诊断。他在 4 周前感染了 SARS-CoV-2。随后,我们诊断为 DM,并开始给予基础-餐时胰岛素治疗。为了探讨糖尿病的病因,我们向患者索取了 C 肽和自身抗体。谷氨酸脱羧酶(GAD)抗体>2000U/mL(参考范围:0-10);因此,该患者被诊断为自身免疫性 T1DM。最近越来越多的报告表明,COVID-19 可引发新发 DM。SARS-CoV-2 病毒利用胰腺中的 ACE2 受体,可进入β细胞并导致这些胰岛细胞受损和胰岛素分泌受损,导致急性糖尿病。此外,SARS-CoV-2 引起的异常免疫也可导致胰岛细胞的自身免疫性破坏。

结论

在遗传易感个体中,T1DM 可能是 COVID-19 病毒引起的一种不常见但可能的并发症。总的来说,该病例强调了预防措施(如接种疫苗)的重要性,以预防 COVID-19 及其并发症。

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