Acute Bilateral Cataract in Type 1 Diabetes Mellitus.

Annals of pediatrics & child health Pub Date : 2015-01-01 Epub Date: 2015-10-02 DOI:10.6084/m9.figshare.13251911.v1
Dimitrios T Papadimitriou, Christina Bothou, Filippos Skarmoutsos, Vassiliki Papaevangelou, Anastasios Papadimitriou
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引用次数: 3

Abstract

We report a case of a 17-year old boy, who presented acute bilateral cataract and complete vision loss within six days, three months after the diagnosis of Type 1 Diabetes Mellitus (T1DM) under optimal metabolic control (HbA1c 6%). At presentation (HbA1c 10.4%) and after correction of diabetic ketoacidosis (pH 6.917) and the beginning of intensified insulin treatment with insulin glargine once daily and insulin aspart before meals,the patient underwent full ophthalmologic examination,which was completely normal. Only few cases with acute bilateral cataract - all relatively shortly after the diagnosis of T1DM - have been reported. Several hypotheses have been drawn but the exact mechanism of this phenomenon remains unclear. The interesting finding in our case was the clearly elevated insulin autoantibodies (IAA) at the time of cataract formation, negative however at presentation. The relation between the elevation of IAA and cataract formation should be further investigated in diabetic patients.

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1型糖尿病并发急性双侧白内障。
我们报告一例17岁的男孩,在最佳代谢控制(HbA1c 6%)下诊断为1型糖尿病(T1DM)后3个月,6天内出现急性双侧白内障和完全视力丧失。患者就诊时(糖化血红蛋白10.4%),糖尿病酮症酸中毒(pH值6.917)纠正后,开始强化胰岛素治疗,每日1次甘精胰岛素,餐前分开胰岛素,患者行全面眼科检查,完全正常。只有少数病例的急性双侧白内障-所有相对较短的诊断T1DM -已被报道。人们提出了几种假设,但这种现象的确切机制尚不清楚。本病例有趣的发现是在白内障形成时胰岛素自身抗体(IAA)明显升高,但在就诊时呈阴性。糖尿病患者IAA升高与白内障形成的关系有待进一步研究。
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