Insulin-dependent diabetes mellitus during alpha-interferon therapy for chronic viral hepatitis

Paolo Fabris, Corrado Betterle, Nella A. Greggio, Renato Zanchetta, Emanuele Bosi, Maria Raffaella Biasin, Fausto De Lalla

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Abstract

A 29-year-old man was observed to develop insulin-dependent diabetes mellitus following a 5-month treatment with recombinant α-2b-interferon for chronic hepatitis C. After the onset of the disease, serum samples that had, respectively, been collected before therapy commencement, at month 3, and at the onset of insulin-dependent diabetes mellitus were tested for islet-cell (ICA-IgG), glutamic acid decarboxylase (GAD-Abs), IA2 (IA2-Abs) and insulin (IA-Abs) autoantibodies. The following results were obtained: ICA-IgG, 5, >80, and >80 JDF-U, respectively; GAD-Abs: >100 U/ml in all three measurements; IA2-Abs and IA-Abs: negative. During treatment, thyroid microsomal autoantibodies increased markedly (from 1:100 to 25 600 titer); thyroid-stimulating hormone was persistently normal. HLA class II typing revealed a genetic predisposition to insulin-dependent diabetes mellitus as demonstrated by the presence of DRB1* 04/08, DQ A1 52 Arg+/Arg+, and DQB1 57 N-Asp/Asp alleles. One year after the onset of insulin-dependent diabetes mellitus, the patient is still receiving 30 IU insulin daily; the liver function tests are normal and HCV-RNA is negative. These data support the hypothesis that, in predisposed patients, α-interferon therapy can enhance an ongoing autoimmune process against pancreatic β-cells and induce overt insulin-dependent diabetes mellitus. We therefore suggest that, in patients with a documented predisposition to insulin-dependent diabetes mellitus, α- IFN therapy should be administered with caution.

Original languageEnglish
Pages (from-to)514-517
Number of pages4
JournalJournal of Hepatology
Volume28
Issue number3
DOIs
Publication statusPublished - Mar 1998

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Chronic Hepatitis
Type 1 Diabetes Mellitus
Interferon-alpha
Glutamate Decarboxylase
Insulin
Autoantibodies
Interferons
Therapeutics
Immunoglobulin G
Liver Function Tests
Chronic Hepatitis C
Thyrotropin
Genetic Predisposition to Disease
Viperidae
Islets of Langerhans
Thyroid Gland
Alleles
RNA
Serum

Keywords

  • α-IFN therapy
  • Autoimmunity
  • HCV
  • Insulin-dependent diabetes mellitus
  • Side effects

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Fabris, P., Betterle, C., Greggio, N. A., Zanchetta, R., Bosi, E., Biasin, M. R., & De Lalla, F. (1998). Insulin-dependent diabetes mellitus during alpha-interferon therapy for chronic viral hepatitis. Journal of Hepatology, 28(3), 514-517. https://doi.org/10.1016/S0168-8278(98)80328-0

Insulin-dependent diabetes mellitus during alpha-interferon therapy for chronic viral hepatitis. / Fabris, Paolo; Betterle, Corrado; Greggio, Nella A.; Zanchetta, Renato; Bosi, Emanuele; Biasin, Maria Raffaella; De Lalla, Fausto.

In: Journal of Hepatology, Vol. 28, No. 3, 03.1998, p. 514-517.

Research output: Contribution to journalArticle

Fabris, P, Betterle, C, Greggio, NA, Zanchetta, R, Bosi, E, Biasin, MR & De Lalla, F 1998, 'Insulin-dependent diabetes mellitus during alpha-interferon therapy for chronic viral hepatitis', Journal of Hepatology, vol. 28, no. 3, pp. 514-517. https://doi.org/10.1016/S0168-8278(98)80328-0
Fabris, Paolo ; Betterle, Corrado ; Greggio, Nella A. ; Zanchetta, Renato ; Bosi, Emanuele ; Biasin, Maria Raffaella ; De Lalla, Fausto. / Insulin-dependent diabetes mellitus during alpha-interferon therapy for chronic viral hepatitis. In: Journal of Hepatology. 1998 ; Vol. 28, No. 3. pp. 514-517.
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