RESUMO
We report a case of type 1 diabetes mellitus during pegylated interferon and ribavirin treatment for chronic hepatitis C, in a young man previously diagnosed with Hashimoto's thyroiditis and vitiligo. The diabetes mellitus occurred during the 12th month of therapy and the cessation of interferon was necessary. Besides anti-islet autoantibodies our patient had also anti-insulin receptor autoantibodies, which explains the type B insulin resistance. One year after interferon discontinuation the patient continues insulin treatment and all the pancreatic autoantibodies are still positive. Patients with autoimmune disorders should be closely monitored and periodically tested for pancreatic autoantibodies during interferon treatment, even in the absence of hyperglycemia.
Assuntos
Antivirais/efeitos adversos , Diabetes Mellitus Tipo 1/induzido quimicamente , Hepatite C Crônica/tratamento farmacológico , Interferon-alfa/efeitos adversos , Polietilenoglicóis/efeitos adversos , Ribavirina/efeitos adversos , Autoanticorpos/sangue , Doenças Autoimunes/imunologia , Diabetes Mellitus Tipo 1/imunologia , Quimioterapia Combinada , Doença de Hashimoto/complicações , Humanos , Resistência à Insulina/imunologia , Ilhotas Pancreáticas/imunologia , Masculino , Proteínas Recombinantes/efeitos adversos , Vitiligo/complicações , Adulto JovemRESUMO
A case of Neisseria elongata subsp. nitroreducens endocarditis with a favourable course is presented. Dental foci were involved as the infective origin. Only conservative therapy was performed for 6 weeks; no complications were registered in 3 months of follow-up. The other 12 cases with similar aetiology communicated in the past 30 y were reviewed.