A Case of Autoimmune Type 1 Diabetes Mellitus Complicated by Myasthenia Gravis and Graves' Disease

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  • Nakajima Shoko
    Department of Internal Medicine, Inazawa City Hospital Department of Endocrinology and Diabetes, Yokkaichi Minucipal Hospital
  • Matsunaga Masaaki
    Department of Internal Medicine, Inazawa City Hospital
  • Shibata Miyuki
    Department of Internal Medicine, Inazawa City Hospital
  • Kusada Noriko
    Department of Internal Medicine, Inazawa City Hospital
  • Nakashima Kotaro
    Department of Endocrinology and Diabetes, Nagoya Daini Red Cross Hospital
  • Inagaki Akemi
    Department of Endocrinology and Diabetes, Nagoya Daini Red Cross Hospital
  • Yasui Keizo
    Department of Neurology, Nagoya Daini Red Cross Hospital
  • Yoshioka Hiromu
    Department of Thoracic Surgery, Nagoya Daini Red Cross Hospital
  • Tsuduki Toyonori
    Department of Diagnostic Pathology, Nagoya Daini Red Cross Hospital
  • Nomura Yoshio
    Department of Internal Medicine, Inazawa City Hospital

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Other Title
  • 重症筋無力症，バセドウ病合併自己免疫性1型糖尿病の1例
  • 症例報告 重症筋無力症,バセドウ病合併自己免疫性1型糖尿病の1例
  • ショウレイ ホウコク ジュウショウキン ムリョクショウ,バセドウビョウ ガッペイ ジコ メンエキセイ 1ガタ トウニョウビョウ ノ 1レイ

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Abstract

A 35-year-old woman with type 1 diabetes was admitted to our hospital after reporting general fatigue, palpitations and diplopia in February 20xy. At 15 years of age, she was started on treatment with insulin therapy for type 1 diabetes. Five years later, she received a diagnosis of myasthenia gravis (MG). On admission, a blood test showed apparent Graves' disease, and the patient's glycemic control was poor. Therefore, we began treatment with an insulin pump in addition to thymectomy for MG followed by the administration of tacrolimus and prednisolone as immunosuppressive therapy. Thereafter, tight glycemic control was maintained with adjustments to the basal injection rate. The patient was therefore given a diagnosis of type 3 polyglandular autoimmune syndrome complicated by type 1 diabetes mellitus, MG and Graves' disease in which the difficult to control diabetes was successfully managed with an insulin pump.

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