Association between islet autoantibodies and the prevalence of autoimmune uveitis

AIM:To evaluate the predictive value of islet autoantibodies for the diagnosis of autoimmune uveitis(AU),as well as to characterize the association bet ween islet autoantibodies and AU.METHODS:Totally 97 patients with AU and 100 healthy persons without any autoimmune diseases as the control group were recruited.Multiple serum islet autoantibodies were measured using commercial enzyme-linked immunosorbent assay kits(ELISA).A supplementary questionnaire was used to complement the subject's demographics and clinical features.The level of glucose concentrations and white blood cells were measured.Conditional logistic regression was performed to estimate odds ratios(ORs),and 95%confidence intervals(CIs)of AU according to islet autoantibodies and to evaluate the predictive value of islet autoantibodies for AU diagnosis.Autoantibodies subgroups and other variables were included into analysis.RESULTS:In AU patients,the prevalence of detecting at least one of the autoantibodies was 31.9%(31/97).The most frequent autoantibody was ZnT8A(30.9%),followed by GADA(11.3%),IA-2A(4.1%),ICA(2.1%)and IAA(2.1%).Islet autoantibodies were found to be correlated positively with AU diagnosis[OR(95%CI):13.86(3.28,58.50),P<0.001].Moreover,Zn-T8A was remarkably correlated with AU diagnosis[OR(95%CI):6.13(1.96,19.17),P<0.001],In contrast,neither GADA nor other islet antibodies(IA-2A,ICA and IAA)showed any association with AU risk under an additive model.CONCLUSION:The prevalence of islet antibodies,especially ZnT8A,in patients with AU is higher.Islet antibodies as well as novel biomarkers should be included in routine evaluation at AU and is a valuable biological marker to classify newly-diagnosed uveitis.

Abrupt onset of type 1 diabetes mellitus during recombinant interferon-alpha 2b therapy in a patient with chronic hepatitis B

We describe a case of a 33-year-old female patient with chronic hepatitis B who developed type 1 diabetes mellitus (DM) after a 13-mo period of treatment with recombinant human interferon-alpha (IFN-α) 2b. The patient presented with polydipsia, polyuria, hypergly-cemia, diabetic ketoacidosis, combined with C-peptide secretion defi ciency and positive islet cell autoantibody (ICAb). IFN-α 2b treatment was terminated and in-stead insulin treatment was initiated. Five months after cessation of the recombinant human IFN-α 2b therapy, the patient remained insulin-dependent. Her serum HBV DNA became negative and serum transaminase returned to the normal level after a 10-mo period of IFN therapy. Type 1 DM induced by IFN-α is relatively rare in patients with chronic hepatitis B. We should pay more attention to patients on IFN-α therapy to avoid destruction of pancreatic beta cells. This is the first case report from China.