Fulminant Type 1 Diabetes Mellitus Complicated with Acute Myocarditis：a Case Report and Analysis

doi:10.12114/j.issn.1007-9572.2021.00.526

Abstract

Abstract: We reported the diagnosis and treatment of a patient with fulminant type 1 diabetes mellitus （FT1DM） with acute myocarditis，and discussed the possible pathogenesis. The FT1DM is a subtype featured by rapid-onset，critical condition，quick progression from hyperglycemia to diabetic ketoacidosis and nearly complete destruction of pancreatic beta cells even just after the onset while the patient is autoantibody negative. The patient that we encountered had a history of upper respiratory tract infection before the onset of FT1DM，and suffered from acute myocarditis one week after the onset of FT1DM，suggesting that FT1DM may be caused by the destruction of islet beta cells due to virus infection，which may be a clue for exploring the pathogenesis of type 1 diabetes. Clinicians should improve their understanding of FT1DM in order to identify it in the early stage and provide an active treatment.

Key words: Diabetes mellitus, type 1；Fulminant type 1 diabetes mellitus；Myocarditis；Case reports

摘要： 本文报道了1例暴发性1型糖尿病合并急性心肌炎患者的诊治过程，探讨了1型糖尿病的发病机制。暴发性1型糖尿病发病急，病情危重，较短时间高血糖后进展为糖尿病酮症酸中毒，发病时胰岛β细胞功能几乎完全破坏，而糖尿病自身抗体阴性。本例患者发病前有上呼吸道感染病史，发病1周后出现急性心肌炎，推测暴发性1型糖尿病可能是病毒感染破坏胰岛β细胞引起，为临床探索1型糖尿病发病机制提供了线索。临床医生应提高对暴发性1型糖尿病的认识，早期识别并积极治疗。

关键词: 糖尿病, 1型；暴发性1型糖尿病；心肌炎；病例报告

YU Fang,WANG Aihua,JIN Jianlan, et al. Fulminant Type 1 Diabetes Mellitus Complicated with Acute Myocarditis：a Case Report and Analysis　[J]. Chinese General Practice, 2021, 24(24): 3129-3133. DOI: 10.12114/j.issn.1007-9572.2021.00.526.
余芳,王爱华,金建兰等. 暴发性1型糖尿病合并急性心肌炎一例诊治分析[J]. 中国全科医学, 2021, 24(24): 3129-3133. DOI: 10.12114/j.issn.1007-9572.2021.00.526.

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