SARS-CoV-2 infection as possible downstream disease precipitator in autoantibody-positive insulin-dependent diabetes mellitus: a case report
Abstract Background SARS-CoV-2 causes lesions, in addition to lung, in endocrine organs such as the pancreas through ACE2 receptor. Recently the relationship between SARS-CoV-2 exposition and the incidence or evolution of clinical autoimmune diabetes has attracted the attention of diabetologists. Ca...
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| Format: | Article |
| Language: | English |
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BMC
2022-02-01
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| Series: | Italian Journal of Pediatrics |
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| Online Access: | https://doi.org/10.1186/s13052-022-01226-5 |
| _version_ | 1818981847117332480 |
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| author | Riccardo Schiaffini Andrea Campana Annalisa Deodati Emanuela Peschiaroli Maria Francesca Lanzillotta Alessandra Fierabracci |
| author_facet | Riccardo Schiaffini Andrea Campana Annalisa Deodati Emanuela Peschiaroli Maria Francesca Lanzillotta Alessandra Fierabracci |
| author_sort | Riccardo Schiaffini |
| collection | DOAJ |
| description | Abstract Background SARS-CoV-2 causes lesions, in addition to lung, in endocrine organs such as the pancreas through ACE2 receptor. Recently the relationship between SARS-CoV-2 exposition and the incidence or evolution of clinical autoimmune diabetes has attracted the attention of diabetologists. Case presentation We report the analysis of the clinical history of a child diagnosed for insulin-dependent diabetes mellitus (Type 1 diabetes) at the time a paucisymptomatic COVID-19 infection occurred, followed by well-controlled metabolic status. As opposite to previous findings SARS-CoV2 did not cause ketosis and ketoacidosis. Polydipsia was reported a few months and weight loss 4 weeks before SARS- CoV-2 infection suggesting that SARS-CoV-2 could not be the trigger of Type 1 diabetes in this patient. Conclusions SARS-CoV-2 in this patient was an unexpected event in the course of disease. We advance the hypothesis that the SARS-CoV-2 infection, even if paucisymptomatic could have acted in the present case report as a hypothetical downstream precipitating factor; whilst the inciting triggering event of the autoimmune disease, as confirmed by the presence of circulating autoantibodies, could have occurred even before, as generally assumed for this category of disorders. The precipitating mechanism could have been the acute interaction between virus and the ACE receptor on the beta cells, at the time that hyperglycemia and glycosuria were ascertained, and HbA1c levels confirmed a metabolic dysregulation over the previous 3 months in absence of ketoacidosis. |
| first_indexed | 2024-12-20T17:37:49Z |
| format | Article |
| id | doaj.art-d3f5103586194b1a95c855372315bf79 |
| institution | Directory Open Access Journal |
| issn | 1824-7288 |
| language | English |
| last_indexed | 2024-12-20T17:37:49Z |
| publishDate | 2022-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Italian Journal of Pediatrics |
| spelling | doaj.art-d3f5103586194b1a95c855372315bf792022-12-21T19:31:11ZengBMCItalian Journal of Pediatrics1824-72882022-02-014811510.1186/s13052-022-01226-5SARS-CoV-2 infection as possible downstream disease precipitator in autoantibody-positive insulin-dependent diabetes mellitus: a case reportRiccardo Schiaffini0Andrea Campana1Annalisa Deodati2Emanuela Peschiaroli3Maria Francesca Lanzillotta4Alessandra Fierabracci5Diabetes and Growth Disorders Unit, Academic Department of Pediatrics, Bambino Gesù Children’s Hospital IRCCSMultispecialistic Pediatric Unit, Emergency Acceptance and General Pediatrics Department, Bambino Gesù Children’s HospitalDiabetes and Growth Disorders Unit, Academic Department of Pediatrics, Bambino Gesù Children’s Hospital IRCCSMultispecialistic Pediatric Unit, Emergency Acceptance and General Pediatrics Department, Bambino Gesù Children’s HospitalInfectivology and Clinical Trials Research Department, Bambino Gesù Children’s Hospital IRCCSInfectivology and Clinical Trials Research Department, Bambino Gesù Children’s Hospital IRCCSAbstract Background SARS-CoV-2 causes lesions, in addition to lung, in endocrine organs such as the pancreas through ACE2 receptor. Recently the relationship between SARS-CoV-2 exposition and the incidence or evolution of clinical autoimmune diabetes has attracted the attention of diabetologists. Case presentation We report the analysis of the clinical history of a child diagnosed for insulin-dependent diabetes mellitus (Type 1 diabetes) at the time a paucisymptomatic COVID-19 infection occurred, followed by well-controlled metabolic status. As opposite to previous findings SARS-CoV2 did not cause ketosis and ketoacidosis. Polydipsia was reported a few months and weight loss 4 weeks before SARS- CoV-2 infection suggesting that SARS-CoV-2 could not be the trigger of Type 1 diabetes in this patient. Conclusions SARS-CoV-2 in this patient was an unexpected event in the course of disease. We advance the hypothesis that the SARS-CoV-2 infection, even if paucisymptomatic could have acted in the present case report as a hypothetical downstream precipitating factor; whilst the inciting triggering event of the autoimmune disease, as confirmed by the presence of circulating autoantibodies, could have occurred even before, as generally assumed for this category of disorders. The precipitating mechanism could have been the acute interaction between virus and the ACE receptor on the beta cells, at the time that hyperglycemia and glycosuria were ascertained, and HbA1c levels confirmed a metabolic dysregulation over the previous 3 months in absence of ketoacidosis.https://doi.org/10.1186/s13052-022-01226-5Type 1 diabetesCOVID-19Disease etiopathogenesisManagement |
| spellingShingle | Riccardo Schiaffini Andrea Campana Annalisa Deodati Emanuela Peschiaroli Maria Francesca Lanzillotta Alessandra Fierabracci SARS-CoV-2 infection as possible downstream disease precipitator in autoantibody-positive insulin-dependent diabetes mellitus: a case report Italian Journal of Pediatrics Type 1 diabetes COVID-19 Disease etiopathogenesis Management |
| title | SARS-CoV-2 infection as possible downstream disease precipitator in autoantibody-positive insulin-dependent diabetes mellitus: a case report |
| title_full | SARS-CoV-2 infection as possible downstream disease precipitator in autoantibody-positive insulin-dependent diabetes mellitus: a case report |
| title_fullStr | SARS-CoV-2 infection as possible downstream disease precipitator in autoantibody-positive insulin-dependent diabetes mellitus: a case report |
| title_full_unstemmed | SARS-CoV-2 infection as possible downstream disease precipitator in autoantibody-positive insulin-dependent diabetes mellitus: a case report |
| title_short | SARS-CoV-2 infection as possible downstream disease precipitator in autoantibody-positive insulin-dependent diabetes mellitus: a case report |
| title_sort | sars cov 2 infection as possible downstream disease precipitator in autoantibody positive insulin dependent diabetes mellitus a case report |
| topic | Type 1 diabetes COVID-19 Disease etiopathogenesis Management |
| url | https://doi.org/10.1186/s13052-022-01226-5 |
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