婴儿糖尿病病理特点及病因(附1例病例报告)

PATHOLOGICAL CHARACTERISTICS AND ETIOLOGY OF INFANTILE DIABETES MELLITUS

1例患糖尿病(IDDM)的4个月男婴,临床发病急骤,3d后死亡。血糖27.9～37.9mmol/L,尿糖+++、尿蛋白+++、尿酮体+++。尸检发现胰腺萎缩,胰岛β细胞明显减少;肾脏增大,肾小球基底膜增厚,系膜基质及系膜细胞增加,肾小管变性;腮腺巨细胞病毒感染。患儿父母系近亲结婚,其母妊7产2,其兄亦于4个月时死于相似症状。对婴儿IDDM的病理特点、病因及发病机理进行了探讨。

A 4-month-infant had sudden onset of IDDM and died at 3 days later. Laboratory examination showed hyperglycemia (27.9～37.9 mmol/L), glycosuria (+++) and high level of ketone bodies in urine (++++). Autopsy revealed: ①atrophy of the pancreas marked decrease of β-cells with insulitis; ②enlargement of the kidneys with thickening of GBM, increase of mesangial matrix and tubular degeneration; ③CMV infection of parotid gland. The patient's parents are of close-relative marrige. His mother has undergone P7 G 2. His elder brother also died of similar clinical manifestation at 4 months old. The pathological characteristics, etiology and pathogenesis of infantile IDDM were discussed.