Endocrine Abstracts

Introduction: Viruses and virus-induced lymphokines may have an important role in the pathogenesis of autoimmunity. The occurrence and significance of autoimmune manifestations after the administration of viral vaccines remain controversial. Herein we have represented a case who developed type 1 diabetes 1 month after vaccination for measles in military.

Case: A 25-year-old male patient admitted to our clinics with the complaints of polyuria, poydipsia, and weight loss. When we questioned his personal history, we have learnt that he had measles vaccination in the army, 1 month ago. In the initial labaratory examinations, plasma glucose was 400 mg/dl, dipstick urine test was ++++ and there was metabolic acidosis with anion gap. After treatment of diabetic ketoacidosis, we skipped to intensive insulin treatment with short and long acting anologue insulins. Since he had very low C-peptide level together with positive anti GAD and anti-islet antibodies, he was diagnosed to have T1DM. His anti TPO was positive and had thyroiditis on ultrasonography. We have screened other components of autoimmune syndrome and found that celiac markers and antiparietal antibodies were negative. He had adequate cortisol response to short cosyntrophin test. He was discharged after regulation of blood glucose levels.

Conclusion: Very few patients may develop some autoimmune diseases following viral vaccination (in particular; arthropathy, vasculitis, neurological dysfunction, and thrombocytopenia). For the majority of people, vaccines are safe and no evidence linking viral vaccines with type 1 diabetes, multiple sclerosis (MS) or inflammatory bowel disease can be found. However there are rare cases in the literature reporting new onset autoimmune diabetes after vaccination. Therefore, it might be reasonable to screen patients who are prone to diabetes for the signs and symptoms of diabetes after vaccination.