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

Interleukin (IL)-2 plays a crucial role in the maintenance of natural immunologic self-tolerance. Neutralization of circulating IL-2 by anti-IL-2 monoclonal antibody for a limited period elicits autoimmune gastritis in BALB/c mice. Similar treatment of diabetes-prone nonobese diabetic mice triggers early onset of diabetes and produces a wide spectrum of T cell-mediated autoimmune diseases, including gastritis, thyroiditis, sialadenitis, and notably, severe neuropathy. Such treatment selectively reduces the number of Foxp3-expressing CD25(+) CD4(+) T cells, but not CD25(-) CD4(+) T cells, in the thymus and periphery of normal and thymectomized mice. IL-2 neutralization inhibits physiological proliferation of peripheral CD25(+) CD4(+) T cells that are presumably responding to normal self-antigens, whereas it is unable to inhibit their lymphopenia-induced homeostatic expansion in a T cell-deficient environment. In normal naive mice, CD25(low) CD4(+) nonregulatory T cells actively transcribe the IL-2 gene and secrete IL-2 protein in the physiological state. IL-2 is thus indispensable for the peripheral maintenance of natural CD25(+) CD4(+) regulatory T cells (T reg cells). The principal physiological source of IL-2 for the maintenance of T reg cells appears to be other T cells, especially CD25(low) CD4(+) activated T cells, which include self-reactive T cells. Furthermore, impairment of this negative feedback loop via IL-2 can be a cause and a predisposing factor for autoimmune disease.
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PMID:Homeostatic maintenance of natural Foxp3(+) CD25(+) CD4(+) regulatory T cells by interleukin (IL)-2 and induction of autoimmune disease by IL-2 neutralization. 1575 6

A familial component to the tendency to develop autoimmune gastritis has long been recognized. Although linkage to certain HLA alleles and an association with the endocrine autoimmune diseases thyroiditis and type 1 diabetes have been reported, little further progress has been achieved in clinical studies. In contrast, the mouse model of gastritis induced in the BALB/c strain by thymectomy in the third day of life has identified four linkage regions; two on distal chromosome 4 (Gasa1 and Gasa2), one on chromosome 6 (Gasa3) and one in the H2 (Gasa4). Three of these four genes colocalize with NOD mouse diabetes susceptibility genes--the strongest concordance identified to date between any two autoimmune diseases--reflecting the association between autoimmune diabetes and type 1 gastritis in humans.
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PMID:Genetic control of susceptibility to autoimmune gastritis. 1576 89

Iron deficiency is a known complication of achlorhydria and may precede the development of pernicious anemia. Among 160 patients with autoimmune gastritis identified by hypergastrinemia and strongly positive antiparietal antibodies, we explored the overlap between 83 subjects presenting with iron deficiency anemia (IDA), 48 with normocytic indices, and 29 with macrocytic anemia. Compared with macrocytic patients, patients with IDA were 21 years younger (41 +/- 15 years versus 62 +/- 15 years) and mostly women. All groups had a high prevalence of thyroid disease (20%) and diabetes (8%) suggestive of the autoimmune polyendocrine syndrome. Stratification by age cohorts from younger than 20 years to older than 60 years showed a regular and progressive increase in mean corpuscular volume (MCV) from 68 +/- 9 to 95 +/- 16 fl, serum ferritin levels from 4 +/- 2 to 37 +/- 41 microg/L, gastrin level from 166 +/- 118 to 382 +/- 299 pM/L (349 +/- 247 to 800 +/- 627 pg/mL), and a decrease in cobalamin level from 392 +/- 179 to 108 +/- 65 pg/mL. The prevalence of Helicobacter pylori infection was 87.5% at age younger than 20 years, 47% at age 20 to 40 years, 37.5% at 41 to 60 years, and 12.5% at age older than 60 years. These findings challenge the common notion that pernicious anemia is a disease of the elderly and imply a disease starting many years before the establishment of clinical cobalamin deficiency, by an autoimmune process likely triggered by H pylori.
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PMID:Variable hematologic presentation of autoimmune gastritis: age-related progression from iron deficiency to cobalamin depletion. 1700 59

Although the clinical significance of gastric xanthelasmas is unclear, they are important lesions because they may be confused with malignant lesions. The etiopathogenesis is also unclear, but chronic gastritis, Helicobacter pylori (H. pylori) infection, diabetes mellitus and hyperlipidemia have been implicated. Xanthelasma is more frequent in women and its incidence increases with age. The lesions are frequently located in the stomach, and less frequently in the esophagus, duodenum and the colon. The lesions have a yellowish-white appearance, are between 0.5 and 10 mm in size and can be single or multiple. Xanthelasmas were found to be associated with chronic gastritis, gastrointestinal anastomoses, intestinal metaplasia, and H. pylori infection. These lesions are predisposing conditions for gastric cancer. Therefore, endoscopic biopsy is mandatory and careful follow-up is required. In this paper, four patients who attended hospital with abdominal pain and dyspepsia and by chance were found to have xanthelasmas on endoscopic examination are presented, and gastric xanthelasmas are discussed.
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PMID:An uncommon lesion: gastric xanthelasma. 1624 31

A 82 year old lady presented with haemorraghic erosive gastritis, progressing lost of weight, hypertension, diabetes mellitus and renal dysfunction. Colour flow duplex scanning and MRA revealed subtotal stenosis of the celiac artery and the right renal artery, proximal occlusion of the superior mesenteric artery and complete occlusion of the inferior mesenteric artery. There were also stenoses in the left renal artery. The patient was accessed via the left brachial artery, because of the relatively unfavourable angle of the mesenteric arteries. The procedures were done using F8-sheath-, F7-guiding catheter and vertebral shaped F5-diagonstic catheter. The celiac trunk und the right renal artery were initially treated with 7 x 12 and 5 x 17 mm balloon-expanding Stents. 7 x 40 mm self-expanding stent (Carotid wallstent) was inserted in the superior mesenteric artery following balloon dilatation with 5-mm-PTA-ballon. Dilatation of the superior mesenteric artery was done also after placement of the stent with 7-mm-PTA-ballon. One stage successful endovascular treatment was performed in the three vascular territories. A follow-up of 3 months period with colour duplex sonography revealed the stent to be patent with normal flow, better control of the hypertension and improvement of the renal function.
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PMID:[Interventional revascularization for severe mesenteric ischemia in contribution with venal artery angioplasty]. 1653 67

To study the clinical and hematologic features of pernicious anemia in Chinese, we describe 181 Chinese with megaloblastic anemia and low serum cobalamin, in association with either classic Schilling test results (82 patients) or the presence of serum antibody to intrinsic factor (99 patients), encountered in a regional hospital in Hong Kong from May 1994 to May 2005. The median age was 75 years (range, 32-95 yr) and the male to female ratio was 1:1.5. The chief presenting feature was anemia, and fewer than 10% of patients presented predominantly with neurologic deficit. Gastric biopsies of 109 patients showed glandular atrophy in 73, endocrine cell hyperplasia in 5, polyps in 14, adenocarcinoma in 1, and chronic gastritis in the rest. Gastric adenocarcinoma occurred in 1.7% of patients after a median follow-up of 35 months (range, 0.5-132 mo). Diabetes mellitus occurred in 24% of patients and thyroid disease in 7%. No specific ABO blood group was associated with pernicious anemia. Serum antibody to intrinsic factor (73%) occurred more frequently than serum antibody to gastric parietal cell (65%) (p=0.353). The frequency of serum antibody to gastric parietal cell was higher in male (78%) than in female patients (53%) (p=0.018). Pernicious anemia is a major cause of megaloblastic anemia in Chinese.
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PMID:Pernicious anemia in Chinese: a study of 181 patients in a Hong Kong hospital. 1672 Dec 55

During the past 10 years, CD4(+)CD25(+)Foxp3(+) regulatory T cells (Treg) have been extensively studied for their function in autoimmune disease. This review summarizes the evidence for a role of Treg in suppression of innate and adaptive immune responses in experimental models of autoimmunity including arthritis, colitis, diabetes, autoimmune encephalomyelitis, lupus, gastritis, oophoritis, prostatitis, and thyroiditis. Antigen-specific activation of Treg, but antigen-independent suppressive function, emerges as a common paradigm derived from several disease models. Treg suppress conventional T cells (Tcon) by direct cell contact in vitro. However, downmodulation of dendritic cell function and secretion of inhibitory cytokines such as IL-10 and TGF-beta might underlie Treg function in vivo. The final outcome of autoimmunity vs tolerance depends on the balance between stimulatory signals (Toll-like receptor engagement, costimulation, and antigen dose) and inhibitory signals from Treg. Whereas most experimental settings analyze the capacity of Treg to prevent onset of autoimmune disease, more recent efforts indicate successful treatment of ongoing disease. Thus, Treg are on the verge of moving from experimental animal models into clinical applications in humans.
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PMID:Regulatory T cells in experimental autoimmune disease. 1683 80

A 60-year-old woman with a history of chronic back pain presented to the emergency department with headache, slurred speech, and altered sensorium reported by her family. The previous day, she had a lumbar catheter placed for symptomatic relief of her chronic back pain. The patient complained only of headache, but otherwise thought she was unaffected. The patient's past medi- cal history was remarkable for diabetes, hypertension, peripheral neuropathy, gastritis, supraventricular tachycardia, and chronic back pain. On physical examination she was alert, fully orientated, and in no acute distress. Her vital signs were normal. Neurological examination revealed subtle word-finding difficulties and dysarthria. There were no physical signs of raised intracranial pressure (ICP). The remainder of her examination was entirely normal.
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PMID:Pneumocephalus secondary to lumbar catheterization. 1696 Feb 96

We report about a 27-year-old female with type I diabetes who was admitted with progressive fatigue and a sudden onset of icterus. As the underlying cause, we found pernicious anemia with hemolytic activity as part of polyglandular autoimmune syndrome (PAS) type II. Under vitamin B(12) substitution we saw a quick rise in hemoglobin and improvement of complaints. Type I diabetes is the most frequent component of PAS II, whereas pernicious anemia is a rather rare component; however, a latent form is seen in about 12% of patients with type I diabetes. Therapy for pernicious anemia consists of parenteral vitamin B(12) substitution. Because of an increased incidence of gastric cancer in chronic atrophic gastritis, endoscopic follow-ups of the chronic atrophic autoimmune gastritis seem to be recommended. Due to the diverse characteristic of PAS II, with development of additional components after years of latency, regular follow-up clinical examinations and lab work are mandatory to detect further need of hormone and vitamin replacement that may sometimes be substantial for survival.
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PMID:[Fatigue and icterus in a 27-year-old patient with diabetes mellitus type I]. 1696 70

Emphysematous gastritis is a rare variant of gastritis that is characterised by the presence of gas in the wall of the stomach with CT scan being the procedure of choice for diagnosis. It is a potentially fatal disease that is caused by gas forming organisms and usually presents with systemic toxicity. Predisposing factors include corrosive ingestion, alcohol abuse, abdominal surgery, diabetes, and immunosuppressant. Antimicrobial therapy with antibiotics covering gram-negative organisms and anaerobes, and surgery in appropriate cases may enhance survival. We report a new case of emphysematous gastritis following pelvic surgery, diagnosed with a CT scan that showed gas in both stomach wall and liver portal venous distribution and recovered with conservative management.
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PMID:Emphysematous gastritis: case report and literature review. 1744 49


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