Emiri Muranaka
Japan
Case Report
Diabetic ketoacidosis due to Simultaneous Acute-Onset Type 1 Diabetes and Graves Disease
Author(s): Chikaaki Kobashi, Emiri Muranaka, Kanako Motoyoshi, Yukihiro Satou, Tadashi Ikeda, Kouichi Shigeta and Masaharu UrakazeChikaaki Kobashi, Emiri Muranaka, Kanako Motoyoshi, Yukihiro Satou, Tadashi Ikeda, Kouichi Shigeta and Masaharu Urakaze
An 18-year old Japanese woman with thirst, weight loss and palpitations for a few weeks’ duration was admitted. Her diagnosis was diabetic ketoacidosis with acute-onset type 1 diabetes (T1D) and Graves’ disease (GD) (autoimmune polyglandular syndrome type 3 variant; APS3v). She was treated with intensification therapy with insulin and anti-thyroid drugs. Human leukocyte antigen testing revealed that her HLA type was HLA- DRB1*08:02-DQA1*03:01-DQB1*03:02 haplotype, which was vulnerable not only to APS3v, but also to both acute-onset T1D and GD. This genetic factor probably contributes to the simultaneous occurrence of T1D and GD.
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