Emergence of anti-islet autoantibodies in Japanese patients with type 1 diabetes

Ichiro Horie; Eiji Kawasaki; Aya Shimomura; Tsuyoshi Satoh; Ikuko Ueki; Hironaga Kuwahara; Takao Ando; Norio Abiru; Toshiro Usa; Katsumi Eguchi

doi:10.1507/endocrj.K10E-068

ORIGINALS

Emergence of anti-islet autoantibodies in Japanese patients with type 1 diabetes

Ichiro Horie, Eiji Kawasaki, Aya Shimomura, Tsuyoshi Satoh, Ikuko Ueki, Hironaga Kuwahara, Takao Ando, Norio Abiru, Toshiro Usa, Katsumi Eguchi

Author information

Ichiro Horie
First Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
Eiji Kawasaki
Department of Metabolism/Diabetes and Clinical Nutrition, Nagasaki University Hospital, Nagasaki, Japan
Aya Shimomura
First Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
Tsuyoshi Satoh
First Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
Ikuko Ueki
First Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
Hironaga Kuwahara
First Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
Takao Ando
First Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
Norio Abiru
First Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
Toshiro Usa
First Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
Katsumi Eguchi
First Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan

Keywords: Type 1 diabetes, Anti-islet autoantibodies, Prediction, Autoimmune polyglandular syndrome type 3, GAD65

JOURNAL FREE ACCESS

2010 Volume 57 Issue 7 Pages 623-628

DOI https://doi.org/10.1507/endocrj.K10E-068

View "Advance Publication" version (May 25, 2010).

Details

Abstract

Circulating anti-islet autoantibodies in sera are used as a predictive marker for type 1 diabetes (T1D). We here report two Japanese patients with autoimmune thyroid disease complicated with T1D in whom the time course of anti-islet autoantibodies were observed before the clinical onset of diabetes. Case 1: A woman who had developed Graves’ disease at age 25 was diagnosed with type 2 diabetes at age 31; six months later, insulin therapy was started. At age 36 she was diagnosed with T1D due to glutamic acid decarboxylase 65 autoantibodies (GAD65Ab)-positive status and decreased C-peptide levels. With stored sera we retrospectively followed her anti-islet autoantibodies. GAD65Ab, zinc transporter 8 autoantibodies (ZnT8Ab) and insulin autoantibodies (IAA) were found to be positive at age 25. IAA soon turned negative, but GAD65Ab and ZnT8Ab remained positive with high levels. Insulinoma-associated antigen-2 autoantibodies (IA-2Ab) emerged 2 years before the initiation of insulin therapy. She has T1D-susceptible HLA-DRB1-DQB1 haplotypes, ^*0405- ^*0401/^*0802-^*0302. Case 2: A 49-year-old woman with hypothyroidism due to 19 years’ history of atrophic thyroiditis noticed marked thirst, polyuria and weight loss. On admission she was diagnosed as T1D due to GAD65Ab-positive findings and poor C-peptide response to i.v. glucagon. Retrospective serology revealed the emergence of GAD65Ab and IAA just after the clinical onset. IA-2Ab and ZnT8Ab never developed. She has T1D-susceptible and -resistant HLADRB1- DQB1 haplotypes, ^*0901-^*0303/^*1502-^*0601. The autoantibody profile and the mode of diabetes onset in the two cases were remarkably different. These cases imply that anti-islet autoantibodies do not always precede the onset of T1D.

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