A case of fulminant type 1 diabetes associated with significant elevation of mumps titers

Endocr J. 2008 Jul;55(3):561-4. doi: 10.1507/endocrj.k07e-126. Epub 2008 Jun 3.

Abstract

Type 1 diabetes mellitus is classified as either autoimmune or idiopathic. Fulminant type 1 diabetes was originally reported as a subtype of idiopathic type 1 diabetes. Though involvement of viral infections has been suggested as a triggering mechanism, its pathogenesis remains unknown. Here, we present a case of fulminant type 1 diabetes associated with significant elevation of mumps titers. A 56-year-old Japanese man had suffered from nausea and generalized fatigue for two days before being transferred to our hospital in a confused state. Findings on admission revealed a high blood glucose level, near-normal HbA1c level, metabolic acidosis, and increased urinary ketone levels. Serum tests for islet-associated autoantibodies were negative. The serum, urinary C-peptide levels and the result of glucagon test indicated severe impairment of insulin secretion. These results were compatible with the diagnosis of fulminant type 1 diabetes. Also, he was suspected as having mumps infection on the basis of serological testing. These findings suggest that fulminant type 1 diabetes developed after mumps virus infection in our case. To the best of our knowledge, no other report has indicated an association between a recent mumps infection and the onset of fulminant type 1 diabetes. This case suggests an association between fulminant type 1 diabetes and mumps virus infection.

Publication types

  • Case Reports

MeSH terms

  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / virology
  • Diabetic Ketoacidosis / blood
  • Diabetic Ketoacidosis / diagnosis*
  • Diabetic Ketoacidosis / etiology*
  • Diabetic Ketoacidosis / virology
  • Humans
  • Male
  • Middle Aged
  • Mumps / blood
  • Mumps / complications*
  • Mumps / diagnosis
  • Mumps / immunology
  • Mumps virus / immunology*
  • Mumps virus / physiology*