Toxic shock syndrome associated with newly diagnosed type 1 diabetes
Date
2000
Authors
Couper, J.
Kallincos, N.
Pollard, A.
Honeyman, M.
Prager, P.
Harrison, L.
Rischmueller, M.
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Advisors
Journal Title
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Volume Title
Type:
Journal article
Citation
Journal of Paediatrics and Child Health, 2000; 36(3):279-282
Statement of Responsibility
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Abstract
Studies of two post-mortem pancreata of children at the onset of type I diabetes have suggested activation and expansion of islet infiltrating T cells by a superantigen. We present the first reported case of a superantigen mediated disease, toxic shock syndrome (TSS), occurring at the diagnosis of type I diabetes. A 12-year-old girl presented with TSS and newly diagnosed diabetes with ketoacidosis. At presentation she was unconscious, febrile and hypotensive, with a desquamating erythematous rash and Kussmaul breathing. During resuscitation, her renal impairment, diarrhoea, thrombocytopaenia and ketoacidosis resolved. Vaginal discharge and blood cultures grew Staphylococcus aureus. T cell studies at 2 weeks after diagnosis detected a high level of spontaneous and islet antigen-specific proliferation with associated interleukin-10 production compared to human leucocyte antigen DR matched controls.