Diabetes mellitus and autoimmunity in patients with the congenital rubella syndrome.
Diabetes mellitus and autoimmunity in patients with the congenital rubella syndrome.
复制标题
先天性风疹综合征患者的糖尿病和自身免疫。
DOI：
10.1093/clinids/7.supplement_1.s170
复制
发表时间：
1985
期刊：
影响因子：
--
通讯作者：
Rubinstein,P
中科院分区：
文献类型：
--
作者：
Ginsberg-Fellner,F;Witt,ME;Fedun,B;Taub,F;Dobersen,MJ;McEvoy,RC;Cooper,LZ;Notkins,AL;Rubinstein,P
据报道，先天性风疹综合征（CRS）患者的胰岛素依赖型糖尿病（IDDM）发病率增加。因此，对CRS儿童的研究对于在易感人群中跟踪IDDM的发展具有重要意义。共评估了242名CRS儿童，其中30名已经患有糖尿病（平均年龄17.4 ± 0.3岁）。在后一组中，HLA DR 3的频率显著增加，HLA DR 2的频率显著降低。虽然在CRS患者总人群的20.2%中发现了胰岛细胞细胞毒性或表面抗体（ICSA），但它们存在于50%-80%的葡萄糖异常患者中。除五名ICSA阳性患者外，所有患者目前均存在血糖异常。此外，在迄今为止评估的DR 3阳性非糖尿病CRS患者中发现葡萄糖耐受不良>50%。这些数据表明，有IDDM风险的CRS患者具有与经典IDDM相同的遗传和免疫学特征，即存在HLA DR 3和缺乏HLA DR 2，以及失代偿前ICSA的高患病率。
An increased incidence of insulin-dependent diabetes mellitus (IDDM) has been reported in patients with congenital rubella syndrome (CRS). Thus, studies of children with CRS would be of great importance in following the development of IDDM in a susceptible population. A total of 242 children with CRS, 30 of whom already have diabetes (mean age, 17.4 ± 0.3 years) have been evaluated. In this latter group, the frequency of HLA DR3 is significantly increased and that of HLA DR2 significantly decreased. While pancreatic islet cell cytotoxic or surface antibodies (ICSA) are found in 20.2% of the total population of patients with CRS, they are present in 50%–80% of patients with glucose abnormalities. In all but five of the ICSA-positive patients, glucose abnormalities are currently present. In addition, glucose intolerance is found in >50% of the DR3-positive nondiabetic patients with CRS evaluated to date. The data demonstrate that patients with CRS at risk for IDDM have the same genetic and immunologic features seen in classic IDDM, namely the presence of HLA DR3 and the absence of HLA DR2 and the high prevalence of ICSA before decompensation.