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- Title
Toxic shock syndrome associated with newly diagnosed type I diabetes.
- Authors
Couper, Jj; Kallincos, N; Pollard, A; Honeyman, M; Prager, P; Harrison, Lc; Rischmueller, M; Couper, J; Couper, J J; Harrison, L C
- Abstract
Studies of two post-mortem pancreata of children at the onset of type I diabetes have suggested activation and expansion of islet infiltrating T cells by a superantigen. We present the first reported case of a superantigen mediated disease, toxic shock syndrome (TSS), occurring at the diagnosis of type I diabetes. A 12-year-old girl presented with TSS and newly diagnosed diabetes with ketoacidosis. At presentation she was unconscious, febrile and hypotensive, with a desquamating erythematous rash and Kussmaul breathing. During resuscitation, her renal impairment, diarrhoea, thrombocytopaenia and ketoacidosis resolved. Vaginal discharge and blood cultures grew Staphylococcus aureus. T cell studies at 2 weeks after diagnosis detected a high level of spontaneous and islet antigen-specific proliferation with associated interleukin-10 production compared to human leucocyte antigen DR matched controls.
- Subjects
TOXIC shock syndrome; DIABETES complications in children; ANTIGEN analysis; AUTOIMMUNE disease diagnosis; ANTIBIOTICS; AUTOIMMUNE diseases; INSULIN; TYPE 1 diabetes; LONGITUDINAL method; SEPTIC shock; STAPHYLOCOCCAL diseases; DISEASE complications
- Publication
Journal of Paediatrics & Child Health, 2000, Vol 36, Issue 3, p279
- ISSN
1034-4810
- Publication type
journal article
- DOI
10.1046/j.1440-1754.2000.00475.x