The histopathology of the pancreas in Type I (insulin-dependent) diabetes mellitus: a 25-year review of deaths in patients under 20 years of age in the United Kingdom (original) (raw)
Summary
A 25-year computerised survey of deaths in the United Kingdom among diabetic patients of 19 years of age and under was performed. Suitable pancreatic material was available in 119 out of the 498 identified patients. The duration of diabetes was known in 95 of the 119 patients. In 60 patients it had been present for less than 1 year. Insulitis was present in 47 of the 60 patients (78%) with recent onset disease, and was also found in 3 patients who had been treated for diabetes for between 1 and 6 years. In cases in which it was identified, insulitis affected 23% of islets containing insulin, but affected only 1% of islets which were insulin deficient, thus supporting the concept that insulitis represents an immunologically mediated destruction of insulin secreting B cells. Four patients appeared to have a different disease from classical Type 1 (insulin-dependent) diabetes in that there was no evidence of insulitis and all islets contained insulin. The age of onset of diabetes was eighteen months or less in these patients.
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References
- Gepts W (1965) Pathologic anatomy of the pancreas in juvenile diabetes mellitus. Diabetes 14:619–33
Google Scholar - Maclean N, Ogilvie RF (1959) Observations on the pancreatic islet tissue of young diabetic subjects. Diabetes 8:83–91
Google Scholar - Doniach I, Morgan AG (1973) Islets of Langerhans in juvenile diabetes mellitus. Clinical Endocrinology 2:233–248
Google Scholar - Junker K, Egeberg J, Kromann H, Nerup J (1977) An autopsy study of the islets of Langerhans in acute-onset juvenile diabetes mellitus. Acta Path Microbiol Scand Sect A 85:699–706
Google Scholar - Foulis AK, Stewart JA (1984) The pancreas in recent-onset Type 1 (insulin-dependent) diabetes mellitus: insulin content of islets, insulitis and associated changes in the exocrine acinar tissue. Diabetologia 26:456–461
Google Scholar - Warnke RA, Gatter KC, Falini B, Hildreth P, Woolston RE, Pulford K, Cordell JL, Cohen B, DeWolf-Peters C, Mason DY (1983) Diagnosis of human lymphoma with monoclonal antileukocyte antibodies. New Engl J Med 309:1275–81
Google Scholar - Shwachman H, Diamond LK, Oski FA, Khan K (1964) The syndrome of pancreatic insufficiency and bone marrow dysfunction. J Paediatr 65:645–663
Google Scholar - Gepts W, De Mey J (1978) Islet cell survival determined by morphology. An immunocytochemical study of the islets of Langerhans in juvenile diabetes mellitus. Diabetes 27 (Suppl 1):251–261
Google Scholar - Bottazzo GF, Dean BM, McNally JM, MacKay EH, Swift PGF, Gamble DR (1985) In situ characterization of autoimmune phenomena and expression of HLA molecules in the pancreas in diabetic insulitis. New Engl J Med 313:353–360
Google Scholar - Bottazzo GF (1984) Beta cell damage in diabetic insulitis: are we approaching a solution? Diabetologia 26:241–249
Google Scholar - Gorsuch AN, Spencer KM, Lister J, McNally JM, Dean BM, Bottazzo GF, Cudworth AG (1981) Evidence for a long prediabetic period in Type 1 (insulin-dependent) diabetes mellitus. Lancet 2:1363–5
Google Scholar - Klöppel G, Drenck CR, Oberholzer M, Heitz PU (1984) Morphometric evidence for a striking B-cell reduction at the clinical onset of Type 1 diabetes. Virchows Arch (Pathol Anat) 403:441–452
Google Scholar - Stefan Y, Orci L, Malaisse-Lagae F, Perrelet A, Patel Y, Unger RH (1982) Quantitation of endocrine cell content in the pancreas of non-diabetic and diabetic humans. Diabetes 31:694–700
Google Scholar - Evans DJ (1972) Generalized islet hypertrophy and beta-cell hyperplasia in a case of long-term juvenile diabetes. Diabetes 21:114–116
Google Scholar
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Authors and Affiliations
- Department of Pathology, Royal Infirmary, G4 OSF, Glasgow, Scotland
A. K. Foulis, C. N. Liddle, M. A. Farquharson, J. A. Richmond & R. S. Weir
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- A. K. Foulis
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Foulis, A.K., Liddle, C.N., Farquharson, M.A. et al. The histopathology of the pancreas in Type I (insulin-dependent) diabetes mellitus: a 25-year review of deaths in patients under 20 years of age in the United Kingdom.Diabetologia 29, 267–274 (1986). https://doi.org/10.1007/BF00452061
- Received: 10 October 1985
- Revised: 03 March 1986
- Issue Date: May 1986
- DOI: https://doi.org/10.1007/BF00452061