Biagio Di Lorenzo, Lucia Pacillo, Giulia Milardi, Tatiana Jofra, Silvia Di Cesare, Jolanda Gerosa, Ilaria Marzinotto, Ettore Zapparoli, Beatrice Rivalta, Cristina Cifaldi, Federica Barzaghi, Carmela Giancotta, Paola Zangari, Novella Rapini, Annalisa Deodati, Giada Amodio, Laura Passerini, Paola Carrera, Silvia Gregori, Paolo Palma, Andrea Finocchi, Vito Lampasona, Maria Pia Cicalese, Riccardo Schiaffini, Gigliola Di Matteo, Ivan Merelli, Matteo Barcella, Alessandro Aiuti, Lorenzo Piemonti, Caterina Cancrini, Georgia Fousteri
The immunological events leading to type 1 diabetes (T1D) are complex and heterogeneous, underscoring the necessity to study rare cases to improve our understanding. Here, we report the case of a 16-year-old patient who showed glycosuria during a regular checkup. Upon further evaluation, stage 2 T1D, autoimmune thrombocytopenic purpura (AITP), and common variable immunodeficiency (CVID) were diagnosed. The patient underwent low carb diet, losing > 8 kg, and was placed on Ig replacement therapy. Anti-CD20 monoclonal antibody (Rituximab, RTX) was administered 2 years after diagnosis to treat peripheral polyneuropathy, whereas an atypical mycobacteriosis manifested 4 years after diagnosis and was managed with prolonged antibiotic treatment...
2022: Frontiers in Immunology