[Early infancy onset of type 1A diabetes mellitus in dizygotic twins: association with genetic and environmental factors]

Arq Bras Endocrinol Metabol. 2007 Feb;51(1):142-5. doi: 10.1590/s0004-27302007000100023.
[Article in Portuguese]

Abstract

The onset of type 1A diabetes before the first year of age is a rare condition and is probably due to an interaction between genetic and environmental factors (infection), which, together, may explain such an early event. Studies say that about 15% of newly diagnosed type 1 diabetic patients had human Cytomegalovirus (CMV) specific viral genome in their lymphocytes. We report two cases of dizygotic twins with type 1 diabetes onset in their first 9 months of age, with genetic homogeneity (for HLA DR3/DR4 alleles), a history of CMV infection (positive IgG and urinary PCR) and positive antibody anti-GAD (9.6 UI/ml), present only in the second twin. Although they were dizygotic twins, which concordance rate is 3.8%, they assume the equivalent risk as monozygotic (40%) as they have similar high risk genotype (HLA) for type 1 diabetes. We believe that both time concordance and also the early onset of diabetes are due to an association between infection and the high genetic liability.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Cytomegalovirus / genetics*
  • Cytomegalovirus Infections / complications*
  • Diabetes Mellitus, Type 1 / genetics*
  • Diabetes Mellitus, Type 1 / virology
  • Diseases in Twins / genetics*
  • Genetic Predisposition to Disease / genetics*
  • HLA-D Antigens / genetics
  • Humans
  • Infant
  • Male
  • Twins, Dizygotic / genetics*

Substances

  • HLA-D Antigens