Ann Pediatr Endocrinol Metab.  2019 Mar;24(1):68-70. 10.6065/apem.2019.24.1.68.

A case of immune-mediated type 1 diabetes mellitus due to congenital rubella ınfection

• Korkmaz HA
• ErmiÅŸ C

• KMID: 2447380
• DOI: http://doi.org/10.6065/apem.2019.24.1.68

Abstract

Congenital rubella infection is a transplacental infection that can cause intrauterine growth retardation, cataracts, patent ductus arteriosus, hearing loss, microcephaly, thrombocytopenia, and severe fetal injury. It has been shown that type 1 diabetes mellitus develops in 12%-20% of patients with congenital rubella infection, and disorders in the oral glucose tolerance test is observed in 40% of patients. No biochemical or serological markers exist which could indicate that type 1 diabetes was caused by a congenital rubella infection. We report a 13-year-old male patient who was admitted to our hospital with complaints of new-onset polyuria, polydipsia, urination, and weight loss. In addition, he was found to have neurosensory hearing loss, patent ductus arteriosus, and microcephaly. Immunemediated type 1 diabetes mellitus was considered due to the fact that the autoantibodies of diabetes mellitus were positive.

Keyword

Rubella; Diabetes; Hearing loss

MeSH Terms

Adolescent
Autoantibodies
Cataract
Diabetes Mellitus
Diabetes Mellitus, Type 1*
Ductus Arteriosus, Patent
Fetal Growth Retardation
Glucose Tolerance Test
Hearing Loss
Humans
Male
Microcephaly
Polydipsia
Polyuria
Rubella*
Thrombocytopenia
Urination
Weight Loss
Autoantibodies

Reference

References

1. Edlich RF, Winters KL, Long WB 3rd, Gubler KD. Rubella and congenital rubella (German measles). J Long Term Eff Med Implants. 2005; 15:319–28.

2. Andrade JQ, Bunduki V, Curti SP, Figueiredo CA, de Oliveira MI, Zugaib M. Rubella in pregnancy: intrauterine transmission and perinatal outcome during a Brazilian epidemic. J Clin Virol. 2006; 35:285–91.

3. Korkmaz HA, Aydın A, Arslan N. Presenting with ısolated hepatitis caused by congenital rubella ınfection due to maternal rubella vaccination. J Pediatr Infect. 2015; 9:38–41.

4. Larsson K, Elding-Larsson H, Cederwall E, Kockum K, Neiderud J, Sjöblad S, et al. Genetic and perinatal factors as risk for childhood type 1 diabetes. Diabetes Metab Res Rev. 2004; 20:429–37.

5. Ginsberg-Fellner F, Witt ME, Fedun B, Taub F, Dobersen MJ, McEvoy RC, et al. Diabetes mellitus and autoimmunity in patients with the congenital rubella syndrome. Rev Infect Dis. 1985; 7 Suppl 1:S170–6.

6. Menser MA, Forrest JM, Honeyman MC, Burgess JA. Letter: Diabetes, HL-A antigens, and congenital rubella. Lancet. 1974; 2:1508–9.

7. Barrett TG, Bundey SE. Wolfram (DIDMOAD) syndrome. J Med Genet. 1997; 34:838–41.

8. Korkmaz HA, Demir K, Hazan F, Yıldız M, Elmas ÖN, Özkan B. Association of Wolfram syndrome with Fallot tetralogy in a girl. Arch Argent Pediatr. 2016; 114:e163–6.

9. Minton JA, Rainbow LA, Ricketts C, Barrett TG. Wolfram syndrome. Rev Endocr Metab Disord. 2003; 4:53–9.

10. Gong M, Simaite D, Kühnen P, Heldmann M, Spagnoli F, Blankenstein O, et al. Two novel GATA6 mutations cause childhood-onset diabetes mellitus, pancreas malformation and congenital heart disease. Horm Res Paediatr. 2013; 79:250–6.

11. Zaharieva ET, Velikova TV, Tsakova AD, Kamenov ZA. Prevalence of positive diabetes-associated autoantibodies among type 2 diabetes and related metabolic and ınflammatory differences in a sample of the Bulgarian population. J Diabetes Res. 2017; 2017:9016148.

12. Nassetta L, Kimberlin D, Whitley R. Treatment of congenital cytomegalovirus infection: implications for future therapeutic strategies. J Antimicrob Chemother. 2009; 63:862–7.

13. Patterson K, Chandra RS, Jenson AB. Congenital rubella, insulitis, and diabetes mellitus in an infant. Lancet. 1981; 1:1048–9.

14. Smithells RW, Sheppard S, Marshall WC, Peckham C, De Prins F, Van Assche FA, et al. Congenital rubella and diabetes mellitus. Lancet. 1978; 311:439–40.

15. Jenson AB, Rosenberg HS, Notkins AL. Pancreatic islet-cell damage in children with fatal viral infections. Lancet. 1980; 2:354–8.