Association of newly diagnosed type 1 diabetes and autoimmune pancreatitis

Abstract

SummaryAutoimmune pancreatitis is a new nosological entity in which a lymphocytic infiltration of the exocrine pancreas is involved. The concomitant onset of autoimmune pancreatitis and type 1 diabetes has been recently described suggesting a unique immune disturbance that compromises the pancreatic endocrine and exocrine functions. We report a case of type1 diabetes onset associated with an autoimmune pancreatitis in a young patient who seemed to present a type 2 autoimmune polyglandular syndrome. This rare association offers the opportunity to better understand pancreatic autoimmune disorders in type 1 diabetes.Learning points:The case makes it possible to understand the possibility of a simultaneous disturbance of the endocrine and exocrine function of the same organ by one autoimmune process.The diagnosis of type 1 diabetes should make practitioner seek other autoimmune diseases. It is recommended to screen for autoimmune thyroiditis and celiac diseases. We draw attention to consider the autoimmune origin of a pancreatitis associated to type1 diabetes.Autoimmune pancreatitis is a novel rare entity that should be known as it is part of the IgG4-related disease spectrum.

Autoimmune Polyglandular Syndrome Type 3 Complicated with IgG4-related Disease

“…Therefore, IgG4-RD, especially AIP, is often complicated by ITP. IgG4-RD has also been reported in conjunction with APS-3, but some studies have focused on the complications of AIP and type 1 DM (also associated with Hashimoto's disease) ( 35 , 36 ), while others have discussed the complications of sclerosing cholangitis and type 1 DM (also associated with Hashimoto's disease) ( 37 ).…”

“…Furthermore, Ennazk et al suggested that cell-mediated autoimmunity could explain the occurrence of AIP and type 1 DM and that individuals carrying HLA DRB1*04:05-DQB1*04:01 are most at risk of complications of AIP and type 1 DM ( 36 , 39 ).…”