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16 May 2024 : Case report  Japan

A Case of Fulminant Type 1 Diabetes with Transient Production of Anti-Glutamic Acid Decarboxylase Antibody

Unusual clinical course, Challenging differential diagnosis

Naka Harada12ABDEF, Hitomi Nakayama12ABCDEF*, Masatoshi Nomura ORCID logo3CF

DOI: 10.12659/AJCR.943590

Am J Case Rep 2024; 25:e943590

Table 1. Laboratory findings at admission.

TestValueReference range
  Red blood cell433×10/µL435–555
  Hemoglobin13.8 g/dL13.7–16.8
  Hematocrit44.20%40.7–50.1
  White blood cell11,400/µL3,300–8,600
  Platelet20.1×10/µL15.8–34.8
  Casual plasma glucose1,327 mg/dL73–109
  Plasma osmolarity359 mOsm/kgHO276–292
  Sodium118 mEq/L138–145
  Potassium5.3 mEq/L3.6–4.8
  Chloride79 mEq/L101–108
  Calcium9.0 mg/dL8.8–10.1
  Phosphate8.1 mg/dL2.7–4.6
  Uric acid11.4 mg/dL3.7–7.8
  Aspartate aminotransferase103 U/L13–30
  Alanine aminotransferase63 U/L10–42
  Lactate dehydrogenase292 U/L124–222
  Alkaline phosphatase270 U/L106–322
  γ-Glutamyl transpeptidase39 U/L13–64
  Total protein6.3 g/dL6.6–8.1
  Albumin4.0 g/dL4.4–5.1
  Urea nitrogen70.5 mg/dL8.0–20.0
  Creatinine1.44 mg/dL0.65–1.07
  Creatine kinase3,287 IU/L59–248
  Creatine kinase-MB106 IU/L0.0–24.9
  C-reactive protein1.34 mg/dL0.00–0.14
  Amylase244 U/L44–132
  Lipase33 U/L11–59
  Trypsin343 ng/mL210–570
  Elastase1140 ng/dL≤300
  Phospholipase A2511 ng/dL130–400
  Total cholesterol210 mg/dL142–248
  Triglyceride404 mg/dL40–234
  Lactate29.2 mg/dL3.0–17.0
Acetoacetic acid3,023 µmol/L<55
  3-Hydroxybutyrate14,012 µmol/L<85
  HbA1c7.20%4.9–6.0
  Glycoalbumin22.30%12.3–16.9
  pH7.1927.35–7.45
  PO120.0 mmHg83–108
  PCO18.6 mmHg35–48
  Bicarbonate6.9 mEq/L22–26
  Base excess−20.1 mEq/L−3.2–1.8
  Specific gravity1.0211.005–1.030
  Glucose(4+)
  Protein(–)
  Ketone bodies(2+)
  C-peptide<0.03 ng/mL0.8–2.5
  TSH0.258 µIU/mL0.4–4.9
  Free T40.81 ng/dL0.7–1.5
  Anti-thyroglobulin antibody<10 IU/mL<28
  Anti-thyroidperoxidase antibody<9 IU/mL<16
  Anti-GAD antibody111 U/mL<5.0
  Anti-IA-2 antibody<0.6 U/mL<0.6
  Anti-nuclear antibody<5.0 IU/mL≤5
  IgG955 mg/dL870–1,700
  IgA305 mg/dL110–410
  IgM84 mg/dL33–190
  Hepatitis C virus(–)
  Hepatitis A virus-IgM(–)
  Hepatitis A virus-IgG(–)
  Cytomegalovirus-IgM(–)
  Cytomegalovirus-IgG(+)
  Epstein-Barr virus-IgM(–)
  Epstein-Barr virus-IgG40
  Epstein-Barr virus-EBNA20
  Adenovirus(–)
  Influenza virus(–)

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923