@article{oai:nagasaki-u.repo.nii.ac.jp:00005287,
 author = {安井, 順一 and 川﨑, 英二 and 原口, 愛 and 池岡, 俊幸 and 植木, 郁子 and 赤澤, 諭 and 堀江, 一郎 and 古林, 正和 and 阿比留, 教生 and 山崎, 浩則 and 川上, 純},
 issue = {2},
 journal = {糖尿病, Journal of the Japan Diabetes Society},
 month = {Mar},
 note = {症例は61歳，女性．54歳時に口渇，体重減少が出現し，近医で随時血糖値598 mg/dl，HbA1c 14.2 ％，尿ケトン体陽性，尿中CPR 28 μg/日にて糖尿病性ケトーシスの診断のもとインスリン療法が開始された．56歳時に血糖コントロール目的で再入院した際，GAD抗体陽性（337.4 U/ml）が判明し，1A型糖尿病と診断された．内因性インスリン分泌能は枯渇しブリットル型糖尿病を呈していたため，当院紹介入院となった．経時保存血清を用いて膵島関連自己抗体の出現様式を検討したところ，1型糖尿病発症時にGAD抗体，IA-2抗体，ZnT8抗体が同時に出現しており，GAD抗体はその後も持続陽性を呈するもIA-2抗体，ZnT8抗体は発症1～3年後には陰性化していた．一般的には順次出現する膵島関連自己抗体の複数同時出現を確認できた症例は非常に稀であり文献的考察を加え報告する., A 61-year-old woman had been diagnosed with diabetic ketosis at 54 years of age due to hyperglycemia (plasma glucose: 598 mg/dl, HbA1c: 14.2 %) and the presence of urinary ketones. She was admitted to a hospital, and insulin therapy was initiated based on her low endogenous insulin secretion (urinary CPR: 28 μg/day). She was admitted to the same hospital again at 56 years of age for glycemic control, at which time, she was diagnosed with type 1A diabetes due to positive GAD antibodies (337.4 U/ml). Her blood glucose level was uncontrollable as a result of exhausted endogenous insulin secretion, and she was referred to our hospital. We examined the emergence pattern of islet-associated autoantibodies using the patient's stored serum samples. Consequently, the simultaneous emergence of autoantibodies to GAD, IA-2, and ZnT8 was detected at the onset of type 1 diabetes. Although GAD antibodies were persistently positive, autoantibodies to IA-2 and ZnT8 became negative within three years after disease onset. The emergence of islet-associated autoantibodies generally occurs before the clinical development of type 1 diabetes. We herein demonstrated a rare case of type 1 diabetes in which islet-associated autoantibodies developed simultaneously, not sequentially., 糖尿病, 57(2), pp.108-112; 2014},
 pages = {108--112},
 title = {発症時に複数の膵島関連自己抗体の同時出現を認めた急性発症1型糖尿病の1例},
 volume = {57},
 year = {2014}
}