Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 51-yr-old, nonobese, male patient presented with hyperglycemia and a recent 40-pound weight loss. Severe insulin resistance was documented in studies in which high amounts of insulin were infused using the Biostator GCIIS. Diabetic control was finally achieved with subcutaneous injections of 470 U of insulin per day. Positive laboratory findings included a mild pancytopenia, elevated erythrocyte sedimentation rate, decreased C3 and properdin, and increased IgA. Antinuclear or other autoantibodies were not present. Insulin antibody levels were within the range usually present in insulin-treated diabetic patients. Acanthosis nigricans was not present. Incubation of the patient's serum with IM-9 lymphoblastoid cells revealed that an insulin receptor antibody was present in a serum dilution of 1:80. Insulin-resistant diabetes mediated by insulin receptor antibodies may present in patients with immunologic findings but without overt dermatologic stigmata.
Diabetes Care
PMID:Insulin-resistant diabetes with insulin receptor autoantibodies in a male patient without acanghosis nigricans. 51 Jan 20

A case is described of Weber-Christian panniculitis accompanied by a gammaglobulin disturbance which preceded by five years the diagnosis of an autoimmune hepatitis and pancytopenia. Also associated was the onset of diabetes mellitus, found at necropsy to be related to pancreatic islet amyloid deposition. This case reinforces the view that Weber-Christian panniculitis may be an adipose response to a variety of immunological stimuli.
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PMID:Weber-Christian panniculitis and auto-immune disease: a case report. 77 34

The case history of a 30-year-old female patient is reported. Following an unknown viral infection that had occurred four years earlier, insulin-dependent diabetes mellitus vitiligo, Addison's disease, amenorrhoea, hyperthyreosis and, finally, severe pancytopenia with dominant thrombocytopenia developed. On the basis of clinical aspects and laboratory findings, an infrequent polyglandular autoimmune syndrome (type II) was verified. Substituent therapy and steroid stoss therapy also was introduced, without any sign of improvement. For the lack of therapeutic effect and owing to serious thrombocytopenic bleeding, treatment with Cyclosporin-A was indicated, which produced total remission of the illness. Nowadays the patient being on follow-up, has no sign of disease activity.
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PMID:Treatment of polyglandular autoimmune syndrome with cyclosporin-A. 134 56

Spontaneous clostridial myonecrosis occurred in 30- and 69-year-old patients with pancytopenia (after treatment of acute myelogenous leukemia) and diabetes with neutropenia respectively. They presented with fever and sudden onset of pain plus tenderness in involved muscles. They rapidly deteriorated and died within hours after admission. A review of the literature for previous reports of this condition disclosed 31 additional cases. Mean age of patients was 50 years, male to female ratio was 2.2:1, and an underlying condition was present in all of them. Presenting manifestations were spontaneously occurring excruciating pain in the involved muscle (67%), generalized sepsis and shock (24%), nonpainful swelling in the involved muscles (6%) and pain, swelling and shock (3%). Mortality rate was 91% (30/33). The clostridial strains associated with this condition were identified in 31 cases, with Clostridium perfringens and C. septicum causing 28 of them. Bacteremia was described in 10 cases. Awareness of this rare catastrophe may aid in early recognition and surgical intervention which are essential for patient survival.
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PMID:Characteristic manifestations of clostridium induced spontaneous gangrenous myositis. 405 70

We have studied a 38-year-old man with a prior diagnosis of Holt-Oram syndrome, who presented with diabetes mellitus. He had recently taken prednisone for idiopathic interstitial lung disease and trimethoprim-sulfamethoxazole for sinusitis. Thrombocytopenia progressed to pancytopenia. The patient had skeletal, cardiac, renal, cutaneous, endocrine, hepatic, neurologic, and hematologic manifestations of Fanconi anemia (FA). Chest radiographs showed increased interstitial markings at age 25, dyspnea began in his late 20s, and he stopped smoking at age 32. At age 38, computerized tomography showed bilateral upper lobe fibrosis, lower lobe honeycombing, and bronchiectasis. Pulmonary function tests, compromised at age 29, showed a moderately severe obstructive and restrictive pattern by age 38. Serum alpha-1 antitrypsin level was 224 (normal 85-213) mg/dL and PI phenotype was M1. Karyotype was 46,XY with a marked increase in chromosome aberrations induced in vitro by diepoxybutane. The early onset and degree of pulmonary disease in this patient cannot be fully explained by environmental or known genetic causes. The International Fanconi Anemia Registry (IFAR) contains no example of a similar pulmonary presentation. Gene-environment (ecogenetic) interactions in FA seem evident in the final phenotype. The pathogenic mechanism of lung involvement in FA may relate to oxidative injury and cytokine anomalies.
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PMID:Interstitial lung disease in an adult with Fanconi anemia: clues to the pathogenesis. 909 63

Werner's syndrome is a rare clinical entity and approximately 150 cases have been reported in the medical literature. Werner's syndrome, inherited by autosomal recessive transmission, is characterized primarily by a short stature, premature greying and balding, trophic ulceration of the legs, diabetes mellitus and hypogonadism. These features combine to present a picture of adult progeria. In this brief report we describe a 51-year-old Bedouin male with Werner's syndrome, diagnosed as erythroleukemia (AML-6), and presenting as acute pancytopenia. The patient died two months after diagnosis. This is a rare case of erythroleukemia in a patient with Werner's syndrome. We survey current knowledge of the cytogenetic pathogenesis of Werner's syndrome and erythroleukemia, and attempt to explain the possible link between these two rare syndromes.
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PMID:A patient with Werner's syndrome and erythroleukemia: just coincidence? 917 19

A patient suffering from infantile-onset insulin-dependent diabetes mellitus is reported in whom immune pancytopenia (Evans' syndrome) developed at the age of 2 1/2 years. Hepatosplenomegaly, chronic lymphadenopathy, and elevated levels of immunoglobulins G and M were also present. The course of Evans' syndrome was fatal in this patient. The association of Evans' syndrome with other immune disorders is discussed.
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PMID:Evans' syndrome in a child with diabetes mellitus. 965 37

The triad of thiamine-responsive anaemia, diabetes mellitus and deafness has been reported in 15 patients with macrocytic anaemia, sometimes associated with moderate thrombocytopenia. The bone marrow aspirate usually shows megaloblastic changes and ringed sideroblasts. However, tri-lineage myelodysplasia has never been reported. We describe two patients who presented with diabetes, deafness and thiamine-responsive pancytopenia. Bone marrow aspirate and biopsy were typical of tri-lineage myelodysplasia. These findings suggest that thiamine may have a role in the regulation of haemopoiesis at the stem cell level. We propose the term 'thiamine-responsive myelodysplasia' rather than that of thiamine-responsive anaemia.
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PMID:Thiamine-responsive myelodysplasia. 973 63

The Japanese low ruled that the patients excreting tubercle bacilli should be treated in the isolated ward for tuberculosis. However, it is often difficult to transfer a patient with serious illness to the isolated ward with insufficient medical facilities. We investigated retrospectively the manner of the management of patients excreting tubercle bacilli in the Aichi Medical University Hospital without the isolation ward for tuberculosis. Materials were 166 patients (0.17%) out of 97,275 in-patients during 11 years since 1986 to 1996. Respiratory symptoms were observed in 114 patients (68.7% of 166 patients) on admission. The initial bacteriological examination was ordered by the attendant doctor within a week in 93 patients (81.6%) of 114 patients with respiratory symptoms. On the other hand, a half of the 52 patients without respiratory symptoms on admission were not examined for sputum bacteriology beyond a week. Anti-tuberculous treatment was started within a week after positive bacteriological results in 129 patients (77.7% of the whole 166 patients), while the treatment was not carried out or delayed in 21 patients (12.6%) because of the communication failure of the bacteriological report to the physicians. Some complications were observed in 101 patients: 21 diabetes mellitus, 20 cancers, 15 hematological disorders, 9 collagen diseases, 6 renal failures on dialysis. Serious illnesses were observed in 33 patients (20.6% of the 166 patients). Twenty-four patients (73% of the seriously ill patients) were died of renal failure, pancytopenia, cancer or respiratory failure. We considered that an isolated room for infectious tuberculosis with independent air conditioning system in a general hospital or a educational hospital was very convenient not only to the treatment of the patients with serious complications, but also to the education and training on tuberculosis for the medical student or medical stuffs.
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PMID:[Management of mycobacteriosis in general hospital without isolation ward for tuberculosis patients. 5. The management of the patients excreting tubercle bacilli in a university hospital without isolation ward for tuberculosis]. 1019 11

Fibrates are widely prescribed as hypolipidemic drugs and are considered as safe. We report the case of a 69 year-old woman who probably developed a major allergic reaction following a Fenofibrate prescription (generic form) of 300 mg per day. Clinical features included asthenia, hyperthermia (40.5 degrees C) and slight muscular pain. Biological abnormalities were mildly elevated muscular enzymes and pancytopenia rapidly developed. All bacteriologic, virologic, immune and radiologic investigations were normal. Evolution was spontaneously favorable with Fenofibrate withdrawal. This is the first reported case of major fever and pancytopenia following a Fenofibrate prescription. Adverse effects of Fenofibrate are briefly reviewed and their usual favorable outcomes following drug removal are outlined.
Diabetes Metab 2001 Feb
PMID:Rare side-effects of fenofibrate. 1124 Apr 49


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