Preview

Meditsinskiy sovet = Medical Council

Advanced search

Clinical case of type 1 diabetes mellitus combined with Graves’ disease and epilepsy

https://doi.org/10.21518/2079-701X-2019-4-108-111

Abstract

The risk of type 1 diabetes mellitus (T1DM) combined with epilepsy is significantly higher in people with this disease than in people without it, which may indicate a genetic predisposition for this combination. The issue of the relationship between diabetes and epilepsy has not yet been fully understood. The article is concerned with a clinical case of type 1 diabetes mellitus combined with Graves' disease in a 37-year-old patient with epilepsy. The combination of two autoimmune diseases can be taken as part of type 2 or 3 autoimmune polyglandular syndrome (APS). APS affects multiple glands in the endocrine system. The chronic adrenal cortex insufficiency is a characteristic sign for the most studied type 1 or 2 APS. Type 3 APS is defined by the presence of an autoimmune thyroid disease and other autoimmune diseases, both endocrine (excluding adrenal and parathyroid gland insufficiency) and nonendocrine. The autoimmune nature of T1DM and Graves' disease is beyond dispute in the considered case; the possibility of considering epilepsy as part of the autoimmune process (like type 3 APS) is not to be irrelevant. The article presents the differential diagnosis of convulsive conditions and comparison of clinical manifestations of hypoglycemia and epileptic seizures, and focuses on the prescription of anticonvulsant therapy in patients with type 1 diabetes. Thyrotoxicosis, which developed against the background of diabetes, leads to high variability of glycemia, increased need for insulin, metabolic decompensation, which requires correction of insulin therapy. Patients with polymorbid conditions should be considered from the perspective of single pathogenesis, and they should be followed-up. If a patient has polyendocrinopathy, the variability of the clinical picture, and pharmacokinetic and pharmacodynamic interaction of the prescribed drugs needs to be taken into account due to mutual influence of pathological processes.

About the Authors

E. N. Smirnova
State Educational Institution of Higher Professional Education Perm State Medical University Ministry of Health of Russian Federation them
Russian Federation

Smirnova Elena Nikolaevna - Dr. of Sci. (Med.), Professor.

614000, Perm, Petropavlovskaya str., 26; Tel.: +7(912) 882-67-06



T. P. Demicheva
State Educational Institution of Higher Professional Education Perm State Medical University Ministry of Health of Russian Federation them
Russian Federation

Demicheva Tatyana Petrovna - Cand. of Sci. (Med.), Associate Professor.

614000, Perm, Petropavlovskaya str., 26; Tel.: +7(912) 582-19-50



References

1. Tokareva S.V., Tokarev A.R., PriLepa A. Manifestation of type 1 diabetes in a patient with epiLepsy occurred in chiLdhood (cLinicaL case and Literature review). Bulletin of new medical technologies. Electronic edition. 2017;3. PubLication 2-11. AvaiLabLe at: http//www.Ohmedtsu.tuLa.EN/VNMT/BuLLetin/E2017-3/2-11.pdf (accessed: 20.07.2018). doi: 10.12737/articLe_59b14e3493b476.46281688. (In Russ.).

2. Larina A.A., Troshina E.A. Autoimmune diseases associated with type 1 diabetes: possibLe mutuaL infLuence. Problems of endocrinology. 2013;1:35-41. (In Russ.).

3. Larina A.A., Troshina E.A., Ivanov O.N. PoLygLanduLar autoimmune syndromes, aduLts: genetic and immu-noLogicheskie diagnostic criteria. Problems of endocrinology2014;3:43-2. (In Russ.).

4. Mancardi M.M., Striano P., Giannattasio A. Type q diabetes and epiLepsy: more than a casuaL association? Epilepsia. 2010;51:320-21.

5. Scherderkina I.O., Rybkina I.G., Petryaykina E.E., KoLtunov I.E. EpiLepsy in chiLdren and adoLescents with type 1 diabetes: features of the course and diagnosis. Pediatrics. 2017;96(1):175-80. (In Russ.).

6. Eeg-OLofsson K.E. Autoimmune aspects of epiLepsy. Mezhdunarodny Nevrologichesky Zhurnal. 2007;3(13). AvaiLabLe at: http//www.mif-ua.com/m/archive/articLe/142. (Accessed date: May 22, 2017).


Review

For citations:


Smirnova EN, Demicheva TP. Clinical case of type 1 diabetes mellitus combined with Graves’ disease and epilepsy. Meditsinskiy sovet = Medical Council. 2019;(4):108-111. (In Russ.) https://doi.org/10.21518/2079-701X-2019-4-108-111

Views: 3854


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2079-701X (Print)
ISSN 2658-5790 (Online)