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Fulminant type 1 diabetes developed after influenza split vaccination

SUMMARY: Fulminant type 1 diabetes (FT1D) is a subtype of diabetes characterized by rapid progression of β-cell destruction, hyperglycemia, and diabetic ketoacidosis (DKA). The pathogenesis of this disease remains unclear. However, viral infections, HLA genes, and immune checkpoint inhibitor use wer...

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Autores principales: Sawamura, Toshitaka, Karashima, Shigehiro, Ohmori, Ai, Sawada, Kei, Aono, Daisuke, Kometani, Mitsuhiro, Takeda, Yoshiyu, Yoneda, Takashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bioscientifica Ltd 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10337240/
https://www.ncbi.nlm.nih.gov/pubmed/37140990
http://dx.doi.org/10.1530/EDM-22-0342
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author Sawamura, Toshitaka
Karashima, Shigehiro
Ohmori, Ai
Sawada, Kei
Aono, Daisuke
Kometani, Mitsuhiro
Takeda, Yoshiyu
Yoneda, Takashi
author_facet Sawamura, Toshitaka
Karashima, Shigehiro
Ohmori, Ai
Sawada, Kei
Aono, Daisuke
Kometani, Mitsuhiro
Takeda, Yoshiyu
Yoneda, Takashi
author_sort Sawamura, Toshitaka
collection PubMed
description SUMMARY: Fulminant type 1 diabetes (FT1D) is a subtype of diabetes characterized by rapid progression of β-cell destruction, hyperglycemia, and diabetic ketoacidosis (DKA). The pathogenesis of this disease remains unclear. However, viral infections, HLA genes, and immune checkpoint inhibitor use were reportedly involved in this disease. A 51-year-old Japanese man with no chronic medical condition was admitted to our hospital with complaints of nausea and vomiting. Cough, sore throat, nasal discharge, and diarrhea were not noted. He had a medical history of at least two influenza infections. His vaccination history was notable for receiving an inactive split influenza vaccine 12 days prior to developing these symptoms. He was diagnosed with DKA associated with FT1D. His HLA class II genotypes were nonsusceptible to FT1D, and he had a negative history of immune checkpoint inhibitor use. The destruction of the pancreas by cytotoxic T cells is reported to be involved in FT1D. Inactive split influenza vaccines do not directly activate cytotoxic T cells. However, these could activate the redifferentiation of memory CD8-positive T cells into cytotoxic T cells and induce FT1D, as this patient had a history of influenza infections. LEARNING POINTS: Influenza split vaccination could cause fulminant type 1 diabetes (FT1D). The mechanism of influenza split vaccine-induced FT1D might be through the redifferentiation of CD8-positive memory T cells into cytotoxic T cells.
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spelling pubmed-103372402023-07-13 Fulminant type 1 diabetes developed after influenza split vaccination Sawamura, Toshitaka Karashima, Shigehiro Ohmori, Ai Sawada, Kei Aono, Daisuke Kometani, Mitsuhiro Takeda, Yoshiyu Yoneda, Takashi Endocrinol Diabetes Metab Case Rep Unique/Unexpected Symptoms or Presentations of a Disease SUMMARY: Fulminant type 1 diabetes (FT1D) is a subtype of diabetes characterized by rapid progression of β-cell destruction, hyperglycemia, and diabetic ketoacidosis (DKA). The pathogenesis of this disease remains unclear. However, viral infections, HLA genes, and immune checkpoint inhibitor use were reportedly involved in this disease. A 51-year-old Japanese man with no chronic medical condition was admitted to our hospital with complaints of nausea and vomiting. Cough, sore throat, nasal discharge, and diarrhea were not noted. He had a medical history of at least two influenza infections. His vaccination history was notable for receiving an inactive split influenza vaccine 12 days prior to developing these symptoms. He was diagnosed with DKA associated with FT1D. His HLA class II genotypes were nonsusceptible to FT1D, and he had a negative history of immune checkpoint inhibitor use. The destruction of the pancreas by cytotoxic T cells is reported to be involved in FT1D. Inactive split influenza vaccines do not directly activate cytotoxic T cells. However, these could activate the redifferentiation of memory CD8-positive T cells into cytotoxic T cells and induce FT1D, as this patient had a history of influenza infections. LEARNING POINTS: Influenza split vaccination could cause fulminant type 1 diabetes (FT1D). The mechanism of influenza split vaccine-induced FT1D might be through the redifferentiation of CD8-positive memory T cells into cytotoxic T cells. Bioscientifica Ltd 2023-04-13 /pmc/articles/PMC10337240/ /pubmed/37140990 http://dx.doi.org/10.1530/EDM-22-0342 Text en © the author(s) https://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Unique/Unexpected Symptoms or Presentations of a Disease
Sawamura, Toshitaka
Karashima, Shigehiro
Ohmori, Ai
Sawada, Kei
Aono, Daisuke
Kometani, Mitsuhiro
Takeda, Yoshiyu
Yoneda, Takashi
Fulminant type 1 diabetes developed after influenza split vaccination
title Fulminant type 1 diabetes developed after influenza split vaccination
title_full Fulminant type 1 diabetes developed after influenza split vaccination
title_fullStr Fulminant type 1 diabetes developed after influenza split vaccination
title_full_unstemmed Fulminant type 1 diabetes developed after influenza split vaccination
title_short Fulminant type 1 diabetes developed after influenza split vaccination
title_sort fulminant type 1 diabetes developed after influenza split vaccination
topic Unique/Unexpected Symptoms or Presentations of a Disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10337240/
https://www.ncbi.nlm.nih.gov/pubmed/37140990
http://dx.doi.org/10.1530/EDM-22-0342
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