HLA Heterogeneity of Insulin-dependent Diabetes Mellitus at Diagnosis: The Pittsburgh IDDM Study
| Autor: | Ronald E. LaPorte, Mark S. Eberhardt, Druie E. Cavender, Allan L. Drash, D. J. Becker, L.H. Kuller, Bruce S. Rabin, Robert W. Atchison, Trevor J. Orchard, D.K. Wagener |
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| Rok vydání: | 1985 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism Human leukocyte antigen Antibodies Viral medicine.disease_cause HLA-DR3 Antigen Sex Factors Diabetes mellitus Epidemiology HLA-DR4 Antigen Internal Medicine medicine Humans Typing Child business.industry Histocompatibility Antigens Class II HLA-DR Antigens Pennsylvania medicine.disease Enterovirus B Human Ketoacidosis Diabetes Mellitus Type 1 Diabetes Mellitus Type 2 El Niño Virus Diseases Child Preschool Immunology Enterovirus Viral disease business |
| Zdroj: | Diabetes. 34:1247-1252 |
| ISSN: | 1939-327X 0012-1797 |
| DOI: | 10.2337/diab.34.12.1247 |
| Popis: | Although some previous studies have suggested that insulin-dependent diabetes mellitus (IDDM) is a heterogeneous condition with variant forms being associated with HLA-DR types, the evidence, thus far, is conflicting. To address this issue, we have examined the presenting characteristics of a consecutive admission series of 200 newly diagnosed cases of IDDM from the Children's Hospital of Pittsburgh. Because HLA-DR frequencies vary by race, data are presented only for the 172 white cases with complete HLA-DR typing. HLADR3 was found more frequently among male cases and DR4 among female cases (P < 0.005). Generally, patients with DR4 presented with a severer clinical picture, being more likely to have impaired consciousness and significant dehydration. In addition, patients with DR4 were more likely to be acidotic, ketotic, and to more frequently report a recent viral infection. This latter finding was supported by a greater frequency of antibodies to Coxsackie-B viruses in the DR4 cases at presentation. These results therefore suggest that there is considerable heterogeneity in IDDM, at least in presenting characteristics, according to HLA-DR type. |
| Databáze: | OpenAIRE |
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