Fulminant type 1 diabetes mellitus associated with Coxsackievirus type B1 infection during pregnancy: a case report

• Published in: Journal of medical case reports 2019-06, Vol.13 (1), p.186-186, Article 186
• Main Authors: Hayakawa, Takahiro, Nakano, Yoshio, Hayakawa, Kana, Yoshimatu, Hiroaki, Hori, Yoshikazu, Yamanishi, Kazuki, Yamanishi, Hirofumi, Ota, Takayuki, Fujimoto, Tokuzo
• Format: Article
• Language: English
• Subjects: Adult; Antibodies; Antigens; Antiviral agents; Antiviral antibody; Antiviral drugs; Blood glucose; Blood Glucose - metabolism; Blood serum; Bradycardia; Case Report; Case reports; Case studies; Cesarean section; Coxsackievirus B1; Coxsackievirus infections; Coxsackievirus Infections - complications; Coxsackievirus Infections - virology; Cytomegalovirus; Development and progression; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - complications; Diabetes, Gestational - blood; Diabetic ketoacidosis; Diabetic Ketoacidosis - etiology; Enterovirus B, Human; Female; Fulminant type 1 diabetes mellitus; Glucose; Glycated Hemoglobin A - metabolism; Glycosylated hemoglobin; Hemoglobin; Hemoglobins; Herpes viruses; Humans; Immunoglobulins; Infection; Infections; Insulin; Insulin aspart; Laboratories; Medical research; Pancreatic beta cells; Peptides; Pregnancy; Pregnant women; Proteins; Risk factors; Type 1 diabetes; Type 2 diabetes; Urine; Viral infections; Virus diseases; Vital signs; Women
• ISSN: 1752-1947; 1752-1947
• DOI: 10.1186/s13256-019-2130-8

Fulminant type 1 diabetes is characterized by an intrinsic insulin deficiency resulting from the severe destruction of pancreatic β cells and it rapidly leads to ketoacidosis. However, the association between fulminant type 1 diabetes in pregnancy and specific viral infections has not been reported. The patient in this study was a 31-year-old Japanese woman, and at 30 weeks of pregnancy she was admitted with marked fatigue. Fetal bradycardia was noted, and the child was delivered by emergency cesarean section but was stillborn. The maternal blood sugar level was high (427 mg/dL), but the glycated hemoglobin value was 6.2%; therefore, fulminant type 1 diabetes was suspected. Serum antibody testing confirmed a Coxsackievirus B1 infection. The patient in this case had fulminant type 1 diabetes in pregnancy associated with Coxsackievirus B1. This case highlights that fulminant type 1 diabetes in pregnancy may be associated with Coxsackievirus B1 infection.