An Autopsy Case of Insulin-Dependent Diabetes Mellitus with Cogan's Syndrome. Involving Severe Systemic Atherosclerosis.:Involving Severe Systemic Atherosclerosis
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We describe a rare autopsy case of IDDM with Cogan's syndrome reported previously. A 42-year-old man who was treated with insulin for15years and with glucocorticoid and β-blocker for 11years was admitted to the hospital because of anorexia. He had been diagnosed as IDDM at the age of 27 and subsequently as Cogan's syndrome with deafness and blindness at the age of 31. Microalbuminuria appeared at35years old and develoed into nephrotic syndrome at 41 years old. He died of progressive uremia with pyuria. For these 15 years, HbAic was8-10%, indicating that his blood glucose levels were constnantly high because he often stopped taking the injection of insulin. Also, he had sustained high blood pressure and hyperlipidemia because of refusing to take the medication continuously.<BR>The pathological findings at autopsy showed a decrease inβcells without hyalinosis in Langerhans islets, advanced diabetic nephropathy with papillary necrosis of the left kidney, severe atherosclerosis of the aorta and systemic arteies without evidence of arteritis, and concentric hypertrophy of the cardiac left ventricle with fibrinous pericarditis. Since Cogan's syndrome is a subtype of polyarteritis nodosa caused by autoimmunity, the severity of the atherosclerosis may be increased by the immunological factor in the pathogenesis of Cogan's syndrome.
- 一般社団法人 日本糖尿病学会の論文
一般社団法人 日本糖尿病学会 | 論文
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