Short Report: Pathophysiology
Development of fulminant Type 1 diabetes with thrombocytopenia after influenza vaccination: a case report
Article first published online: 7 DEC 2011
© 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK
Volume 29, Issue 1, pages 88–89, January 2012
How to Cite
Yasuda, H., Nagata, M., Moriyama, H., Kobayashi, H., Akisaki, T., Ueda, H., Hara, K. and Yokono, K. (2012), Development of fulminant Type 1 diabetes with thrombocytopenia after influenza vaccination: a case report. Diabetic Medicine, 29: 88–89. doi: 10.1111/j.1464-5491.2011.03391.x
- Issue published online: 7 DEC 2011
- Article first published online: 7 DEC 2011
- Accepted manuscript online: 22 JUL 2011 10:31AM EST
- Accepted 18 July 2011
- fulminant Type 1 diabetes;
Diabet. Med. 29, 88–89 (2012)
Background Fulminant Type 1 diabetes was originally reported as idiopathic Type 1 diabetes. Involvement of viral infections in the pathogenesis of fulminant T1D has been suggested, but the development of fulminant Type 1 diabetes after influenza vaccination has not been reported.
Case Report We report a case of fulminant Type 1 diabetes with thrombocytopenia following influenza vaccination. A 54-year-old man was admitted to hospital with hyperglycaemia and diabetic ketosis. Seven days before admission, he received a seasonal influenza vaccine for the prevention of influenza infection. On admission, blood glucose was 29 mmol/L and HbA1c 40 mmol/mol (5.9%). Fasting and 2-h C-peptide immunoreactivity were <0.0333 nmol/L and 0.0999 nmol/L, respectively. Anti-GAD and anti-IA-2 antibodies were negative, so no autoimmunity seemed to participate in the etiology. ELISPOT assay also showed no association with T cell-mediated autoimmunity. HLA genotypes were consistent with susceptibility to fulminant Type 1 diabetes. After the abrupt onset of diabetes, he showed mild thrombocytopenia, which has been observed for approximately 5 years after diabetes development.
Conclusion This is the first description of fulminant Type 1 diabetes after influenza vaccination. Our observation raises the possibility that influenza vaccination might trigger this condition via the TLR7 pathway.