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BMJ Case Reports 2012; doi:10.1136/bcr-2012-006560
  • Rare disease

Fulminant type 1 diabetes mellitus

  1. Kazuaki Shinohara1
  1. 1Department of Emergency and Critical Care Medicine, Ohta Nishinouchi Hospital, Koriyama, Fukushima, Japan
  2. 2Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
  3. 3Department of Pathology, Ohta Nishinouchi Hospital, Koriyama, Fukushima, Japan
  1. Correspondence to Dr Ryota Inokuchi, inokuchir-icu{at}h.u-tokyo.ac.jp

We present a fatal case of fulminant type 1 diabetes mellitus that was initially diagnosed as upper respiratory tract infection based on pharyngeal redness at a clinic. However, the patient then went into cardiopulmonary arrest, and was transferred to our hospital for treatment. Testing revealed very high levels of blood glucose (86.9 mmol/l), urinary glucose (2+) and ketones (4+). His glycosylated haemoglobin level was almost normal (6.2%; normal <6.2%). Autopsy revealed marked depletion and atrophy of the islets of Langerhans.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

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