Myocarditis with fulminant type 1 diabetes mellitus diagnosed by cardiovascular magnetic resonance imaging: a case report

Makino, Katsuhiro; Nishimae, Ikiko; Suzuki, Noriyuki; Nitta, S; Saitoh, Hiroki; Kasao, Masashi; Takazawa, Kazunaga

doi:10.1186/1756-0500-6-347

Cited by 5 publications

(8 citation statements)

References 8 publications

(9 reference statements)

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“…Figure 4 presents a summary of previously reported cases of simultaneous type 1 diabetes onset and myocarditis. [11][12][13][14] No similar trends in age, sex, HLA-DR, or HLA-DQ were observed. However, all patients exhibited a combination of FT1D and myocarditis within 2 weeks after flu-like symptoms with fever.…”

Section: Discussionmentioning

confidence: 97%

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Fulminant Type 1 Diabetes Mellitus and Fulminant Viral Myocarditis

et al. 2015

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SummaryA 35-year-old Japanese woman was admitted with coma following flu-like symptoms. She was diagnosed with diabetic ketoacidosis and fulminant type 1 diabetes (FT1D) and received intravenous infusion of insulin and saline. The next day, the ketoacidosis disappeared, and she recovered consciousness. However, extensive ST-segment elevations in the electrocardiogram appeared with a positive troponin test, and the patient developed pulmonary edema on day 3. An echocardiogram showed globally reduced wall motion of the left ventricle and mild pericardial effusion. Despite medical therapy with intravenous furosemide, carperitide, and catecholamines, her cardiac function deteriorated rapidly, with the left ventricular ejection fraction decreasing to 26% within 7 hours, and progressed to cardiogenic shock that afternoon. The patient received mechanical circulatory support for 4 days with intra-aortic balloon pumping and percutaneous cardiopulmonary support, and recovered fully from circulatory failure. A paired serum antibody test showed a significantly elevated titer against parainfluenza-3 virus, indicating a diagnosis of fulminant viral myocarditis. She was discharged on multiple daily insulin injection therapy, and her subsequent clinical course has been uneventful. In summary, we present a case of concurrent FT1D and fulminant viral myocarditis. Parainfluenza-3 viral infection was confirmed serologically and was considered to be a cause of both the FT1D and fulminant myocarditis. (Int Heart J 2015; 56: 239-244)

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Section: Discussionmentioning

confidence: 97%

“…10) Several cases of concurrent type 1 diabetes and myocarditis have been reported. [11][12][13][14] Here, we report a patient with concomitant FT1D and fulminant viral myocarditis related to parainfluenza-3 infection and review reported cases of simultaneous type 1 diabetes and myocarditis.…”

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confidence: 99%

Fulminant Type 1 Diabetes Mellitus and Fulminant Viral Myocarditis

et al. 2015

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“…The association between type II diabetes mellitus and viral infections has not been strongly established in the literature. Different viral infections including mumps, measles, echovirus, Epstein-Barr virus (EBV), and coxsackievirus have been traditionally associated with the onset of type I diabetes mellitus [ 4 - 8 ]. In one study, three patients, who developed ketosis-prone diabetes mellitus immediately after documented viral infection with EBV or coxsackievirus and required insulin therapy on discharge, were followed for four to eight years; the first patient remained insulin-dependent throughout the life, the second one regained normal glucose tolerance, and the third one was being transitioned to oral antidiabetic medications [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Onset of Ketosis-Prone Diabetes in the Setting of COVID-19 Infection

Siddiqui¹,

Zirkiyeva²,

Saliaj³

2020

Cureus

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Diabetic ketoacidosis is typically associated with type I diabetes mellitus, but it can be associated with type II diabetes mellitus under the conditions of extreme stress or as a presenting manifestation of ketosis-prone type II diabetes mellitus. A 38-year-old prediabetic male presented to the emergency room with hyperglycemia six weeks after recovery from coronavirus disease 2019 (COVID-19) pneumonia. Laboratory results showed severe hyperglycemia, metabolic acidosis, positive ketones in urine and blood, and elevated fasting C- peptide level. COVID-19 polymerase chain reaction (PCR) was negative, and immunoglobulin G (IgG) antibodies were positive. The workup was completely unremarkable for acute infection. Hemoglobin A1C increased from 6.1% to 10.8% within six weeks. The mechanism by which COVID-19 infection may trigger the onset of full-blown diabetes mellitus remains unknown. Viral infection may cause the direct destruction of pancreatic beta cells or trigger the changes in the body that induce the state of insulin resistance. Antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may cross-react or interfere with the functioning of endogenous insulin. The association between type II diabetes and COVID-19 infections needs additional investigations to ascertain the exact mechanism by which COVID-19 infection triggers the onset of full-blown diabetes mellitus.

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“…Indeed, some cases showing a definite association with acute pancreatitis have been reported [ 3 , 4 ]. Several cases of FT1D also reportedly exhibited myocarditis [ 5 – 8 ]. To our knowledge, however, no prior reports on FT1D have documented a patient who showed acute pancreatitis and myocarditis within 1 week.…”

Section: Discussionmentioning

confidence: 99%

“…However, the etiology of FT1D remains elusive. Several cases with concomitant acute pancreatitis [ 3 , 4 ] or myocarditis [ 5 – 8 ] during the clinical course of FT1D were previously reported. Herein, we describe a 31-year-old Japanese woman with FT1D who was initially diagnosed with acute pancreatitis and then developed diabetic ketoacidosis and myocarditis.…”

Section: Introductionmentioning

confidence: 99%

A rare case of fulminant type 1 diabetes mellitus accompanied by both acute pancreatitis and myocarditis - case report

et al. 2020

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Background: Fulminant type 1 diabetes mellitus (FT1D) is a newly established subtype of type 1 diabetes. Its etiology has not been fully elucidated. Several cases with FT1D have exhibited pancreatitis or myocarditis. Case presentation: We report a 31-year-old Japanese woman who showed upper abdominal pain and was admitted to a local hospital. She was initially diagnosed with acute pancreatitis based on serum amylase elevation and swelling of the pancreas on computed tomography. Four days after admission, she developed diabetic ketoacidosis and was transferred to our hospital. Her symptoms and laboratory findings met the FT1D criteria. On the 3rd hospital day, electrocardiography (ECG) showed ST-segment elevation, and serum cardiac enzymes were markedly elevated. Because she exhibited late gadolinium enhancement in the apical wall on contrast-enhanced cardiac magnetic resonance imaging, she was diagnosed as acute myocarditis. Abnormal ECG findings and elevations of biomarkers associated with myocarditis showed improvement on the next day. Conclusions: This is the first case of FT1D accompanied by both pancreatitis and myocarditis and suggests that the pathophysiology of FT1D is related to the common etiology of acute pancreatitis and myocarditis.

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Myocarditis with fulminant type 1 diabetes mellitus diagnosed by cardiovascular magnetic resonance imaging: a case report

Cited by 5 publications

References 8 publications

Fulminant Type 1 Diabetes Mellitus and Fulminant Viral Myocarditis

Fulminant Type 1 Diabetes Mellitus and Fulminant Viral Myocarditis

Onset of Ketosis-Prone Diabetes in the Setting of COVID-19 Infection

A rare case of fulminant type 1 diabetes mellitus accompanied by both acute pancreatitis and myocarditis - case report

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