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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between 1960 and 1976 117 patients underwent pituitary implantation with yttrium-90 (90Y) for treatment of proliferative retinopathy at the Hammersmith Hospital, London. Mean age at operation was 35 +/- 11 years (mean +/- SD), and mean duration of diabetes 18.6 +/- 10.0 years. Mean insulin dosage prior to implant was 67.2 +/- 24 units, falling to 30.4 +/- 14.9 units post-implant. Thirty-two per cent of patients are still living, 60% are deceased and 8% are lost to follow-up. The 5-year survival rate was 82%. Of the causes of death, 21% died of infection, adrenal insufficiency or hypoglycaemia, 12% of renal failure, and 47% of myocardial or cerebral vascular disease. Ophthalmological follow-up was carried out on the 100 patients operated on between 1965 and 1976. The mean age of this group at implant was 35 +/- 10.5 years, and mean duration of diabetes 17.2 +/- 8.7 years. Visual acuity in the better eye at operation was 6/12 or better in 84% of patients, and this percentage remained similar at the time of the 5 and 10 year follow-up. Blindness (6/60 or worse) in both eyes was present in 12% of patients at the time of 5 and 10 year assessments. By 5 years new vessels on the disc had improved from a mean grading of 2.7 +/- 1.6 to 0.8 +/- 1.2 (p less than 0.001), and by 10 years there was no disc neovascularisation in any eye. There was a similar improvement in the grading of hard exudates, microaneurysms and haemorrhages, but there was an increase in fibrous retinitis proliferans.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Long-term follow-up of patients who underwent yttrium-90 pituitary implantation for treatment of proliferative diabetic retinopathy. 243 1

We report the case of a 54 year old male with diabetes insipidus and diabetes mellitus who developed, twenty years later, signs of hypogonadotropic hypogonadism, secondary adrenal insufficiency and primary hypothyroidism with positive serum antithyroglobulin antibodies. At that time, an osteolytic lesion on the left temporal bone was localized by radiologic studies. A bone biopsy confirmed the diagnosis of eosinophilic granuloma. Laboratory tests also showed anemia, hypergammaglobulinemia and accelerated eritrosedimentation rate which constitute atypical manifestations of this rare disease in adults. The probable etiopathogenic mechanisms are discussed: while some authors have described an autoimmune primary defect, others have suggested a primary viral infection as the cause of Hand-Schuller-Christian disease. The association of direct and indirect evidence of immunologic alterations in our patient is suggestive of an autoimmune origin.
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PMID:[Infrequent clinical manifestations in a patient with eosinophilic granuloma]. 248 46

A 44 year old man with longstanding diabetes mellitus gave a 6-month history of periodic attacks of flaccid quadriplegia. Following one of these episodes he was admitted for assessment. In view of persistent hyperkalaemia, hypoadrenalism was suspected and Addison's disease was confirmed biochemically. Adrenal replacement therapy restored the potassium levels to normal and resulted in no further attacks of paralysis.
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PMID:Hyperkalaemic periodic paralysis: a rare presentation of Addison's disease. 259 1

Basal immunoreactive serum trypsin (RIT) was determined in comparative study of 46 patients with adrenocortical hyperfunction and 24 patients with hypocorticism for specifying the potentialities of the diagnostic test. Excess of endogenous corticosteroids is accompanied by a marked increase in the RIT serum concentration, this increase is particularly pronounced in Itsenko-Cushing syndrome and in exacerbations of Itsenko-Cushing disease in comparison with its level in Itsenko-Cushing disease remission. The presence of steroid diabetes had no significant RIT changes in Itsenko-Cushing disease. Attendant chronic pancreatitis that developed in patients with adrenocortical hyperfunction had no influence on blood serum RIT content. In patients with adrenal steroid deficiency who did not take glucocorticoids the serum RIT concentration was lower than that in those who constantly used hormones. RIT is increased in cases of chronic pancreatitis combined with chronic adrenal insufficiency. Measurement of the basal serum RIT may contribute to the diagnosis of pancreatitis in patients with hypocorticism but provides no information on this pathology in patients with endogenous hypercorticism.
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PMID:[Immunoreactive trypsin in the blood serum of patients with endogenous hypercorticism]. 277 53

Five Persian Jews were detected with the polyglandular deficiency syndrome (PDS). Primary hypoparathyroidism and hypogonadism were present in each, adrenal insufficiency in two, and insulin-dependent diabetes mellitus and latent hypothyroidism in single subjects. The percentage of T and B cells, and the mononuclear cell response to phytohemagglutinin and Concanavalin A were normal in all five. IgG and IgA levels and the OKT4+/OKT8+ cell ratio were low in one subject. Antinuclear and antithyroid antibodies were present in one subject. HLA-DR5 was present in 4/4, HLA-24 and B5 (B51) in 3/4 subjects. A single case of isolated hypoparathyroidism (IHP) was detected among 12 first degree relatives. HLA antigens B8, DR3, were absent in all of these subjects. Seven non-Iranian Jews with IHP were also examined. HLA A26 or A25 were present in all seven. Persian Jews appear to have a unique variant of PDS.
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PMID:The polyglandular deficiency syndrome: a new variant in Persian Jews. 349 74

Dysfunction of multiple endocrine glands may develop as the result of hypopituitarism, various infiltrative disorders, or an organ-specific autoimmune mechanism. When dysfunction of two or more endocrine glands occurs in association with circulating organ-specific antibodies directed against the involved glands, the term polyglandular autoimmune syndrome is applied. Characteristics of polyglandular autoimmunity include specific patterns of disease association and frequently a family history of similar involvement. The principal endocrine components of these syndromes are adrenal insufficiency, autoimmune thyroid disease, insulin-dependent diabetes mellitus, and premature gonadal failure. In addition, primary hypoparathyroidism is a key feature of one form of polyglandular autoimmunity that occurs in children. Several nonendocrine organ-specific autoimmune disorders are also associated with polyglandular autoimmunity, of which pernicious anemia is the most frequent. The underlying abnormality responsible for polyglandular autoimmunity is most likely a defect in T suppressor cell function, but there is evidence that aberrant expression of HLA DR antigens also plays an important role in the pathogenesis of these disorders.
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PMID:Polyglandular autoimmune syndromes. 389 41

To evaluate the role of insulin receptors in the pathogenesis of insulin resistance observed in glucocorticoid excess, we measured 125I-insulin binding to circulating erythrocytes in 7 patients with Cushing's syndrome and 7 patients with adrenal insufficiency. Insulin receptor binding was higher in Cushing's syndrome and was lower in adrenal insufficiency, compared to normal subjects. Insulin binding decreased after transsphenoidal surgery in 2 patients with Cushing's syndrome. In addition, glucocorticoid treatment in 6 patients with adrenal insufficiency resulted in the increase of insulin binding. The biological significance of this phenomenon must await further investigation, but it does suggest that insulin resistance in glucocorticoid excess should be interpreted as an alteration of cellular mechanisms of insulin at a step distal to the insulin receptor. Increased insulin binding to the receptor is probably modulated by postreceptor events.
Diabetes Res Clin Pract 1985 Dec
PMID:The effect of glucocorticoid on 125I-insulin binding to human erythrocytes. Possible postreceptor modulation of receptor binding. 391 63

A 57-year-old white man manifested adrenal insufficiency, insulin-dependent diabetes mellitus reflected by diabetic ketosis, primary hypothyroidism, and primary hypogonadism on rapid withdrawal of glucocorticoid therapy of several years' duration for rheumatoid arthritis. Resumption and continuation of glucocorticoid therapy for six months resulted in remission of type I diabetes mellitus and hypogonadism, and a euthyroid state was achieved by replacement therapy with L-thyroxine.
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PMID:Onset of type I diabetes mellitus, hypothyroidism, and hypogonadism on withdrawal of glucocorticoid therapy and remission on its resumption in a patient with rheumatoid arthritis. 394 47

The association of pernicious anemia, an autoimmune disease, with other immunologic disorders such as dermatitis herpetiformis, Hashimoto's thyroiditis, hypothyroidism, hyperthyroidism, vitiligo, adrenal insufficiency, adult-onset immunoglobulin deficiency, hypoparathyroidism, and possibly diabetes mellitus has been reported. The association of pernicious anemia with giant cell myocarditis, a rare fatal illness believed by some to represent an autoimmune abnormality occurring with other autoimmune diseases such as thymoma, systemic lupus erythematosus, dermatomyositis, thyrotoxicosis, Wegener's granulomatosis, and Sjogren's syndrome, is reported for the first time. A common underlying autoimmune abnormality is suggested.
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PMID:Pernicious anemia and giant cell myocarditis. New association. 397 60

Thirty-four insulin-dependent diabetics with a coexistent organ-specific autoimmune disease (Graves' disease, primary myxedema, adrenal insufficiency, generalized vitiligo, primary biliary cirrhosis) were compared to 100 insulin-dependent patients in whom no obvious etiology was detectable. The autoimmune group was characterized by a predominance of females, a family history of autoimmune disease, a later age at onset, better glycemic control, low insulin requirement, persistence of ICA, and greater frequency of HLA B8 but not of B18. However, there was a large overlap between the two groups for all these criteria. In addition, a family history of IDD in first degree relatives and the frequency of serum positive for neutralizing anti-Coxsackie B antibodies were identical in the two groups. These results do not justify the separation of this group of patients as having purely autoimmune diabetes, to the exclusion of other etiological factors, whether genetic or viral.
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PMID:Clinical characteristics and etiological markers in insulin-dependent diabetes associated with an organ-specific autoimmune disease. 631 21


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