RESUMEN
BACKGROUND: The incidence of type 1 diabetes mellitus (T1DM) in Sardinia is among the highest in the world (44.8 cases/100,000 person-years). Recommendations of the Immunology of Diabetes Society advise evaluating autoantibody positivity in first-degree relatives (FDRs) of patients with T1DM, for their higher risk to develop the disease. The aim of this study was to determine the prevalence of beta-cell autoimmunity in FDRs of T1DM patients in Sardinia. METHODS: A total of 188 Sardinian families were recruited in collaboration between diabetes and pediatric units of university and district hospitals in Sardinia. The recruitment involved 188 patients with diagnosed T1DM and all their available FDRs (n = 447). Autoantibodies (Aabs) against GAD, IA2, insulin, and ZnT8 were measured in all subjects. Human leukocyte antigen (HLA) risk genotypes (HLA-DR and DQ loci) were analyzed in 43 Aabs-positive FDR. RESULTS: The prevalence of Aabs (any type of autoantibody, single or multiple) in FDR was 11.9% (53/447). Of those with autoantibodies, 62.3% (33/53) were positive to only 1 autoantibody, 22.6% (12/53) had 2 autoantibodies, 7.55% (4/53) had 3 autoantibodies, and 7.55% (4/53) had all 4 autoantibodies. Typing of HLA-DR and DQ loci showed that 89% of FDR carried moderate- to high-risk genotypes, with only 5 FDR with low-risk genotypes. CONCLUSIONS: The prevalence of T1DM autoantibodies in FDRs of T1DM patients was very high (11.9%) in the Sardinian population, higher than in other populations from the United States and Europe, and similar to that observed in Finland. Autoantibody positivity strongly associated with HLA risk. This study provides evidence of the high risk of T1DM in FDR of T1DM patients in Sardinia and warrants longitudinal follow-up to estimate the risk of progression to T1DM in high-risk populations.
Asunto(s)
Autoanticuerpos/inmunología , Enfermedades Autoinmunes/epidemiología , Autoinmunidad/inmunología , Diabetes Mellitus Tipo 1/fisiopatología , Antígenos HLA-DQ/inmunología , Antígenos HLA-DR/inmunología , Islotes Pancreáticos/inmunología , Adolescente , Adulto , Enfermedades Autoinmunes/genética , Enfermedades Autoinmunes/inmunología , Biomarcadores/análisis , Niño , Familia , Femenino , Estudios de Seguimiento , Predisposición Genética a la Enfermedad , Humanos , Italia/epidemiología , Masculino , Prevalencia , Pronóstico , Adulto JovenRESUMEN
A case of rupture of an aneurysm of the right middle cerebral artery with ventricular inundation of the contrast medium during angiography is reported. The various causal factors in the rupture of the aneurysmatic sack during this examination are discussed. In particular, the implications of sudden changes in arteriolar pressure induced by the contrast medium when preexistent arterioral and encephalic lesions of organic or functional nature are present, are considered.