학술논문
Toxic shock syndrome associated with newly diagnosed type I diabetes.
Document Type
Journal Article
Author
Source
Subject
*TOXIC shock syndrome
*DIABETES complications in children
*ANTIGEN analysis
*AUTOIMMUNE disease diagnosis
*ANTIBIOTICS
*AUTOIMMUNE diseases
*INSULIN
*TYPE 1 diabetes
*LONGITUDINAL method
*SEPTIC shock
*STAPHYLOCOCCAL diseases
*DISEASE complications
*
*
*
*
*
*
*
*
*
*
*
Language
ISSN
1034-4810
Abstract
Studies of two post-mortem pancreata of children at the onset of type I diabetes have suggested activation and expansion of islet infiltrating T cells by a superantigen. We present the first reported case of a superantigen mediated disease, toxic shock syndrome (TSS), occurring at the diagnosis of type I diabetes. A 12-year-old girl presented with TSS and newly diagnosed diabetes with ketoacidosis. At presentation she was unconscious, febrile and hypotensive, with a desquamating erythematous rash and Kussmaul breathing. During resuscitation, her renal impairment, diarrhoea, thrombocytopaenia and ketoacidosis resolved. Vaginal discharge and blood cultures grew Staphylococcus aureus. T cell studies at 2 weeks after diagnosis detected a high level of spontaneous and islet antigen-specific proliferation with associated interleukin-10 production compared to human leucocyte antigen DR matched controls. [ABSTRACT FROM AUTHOR]