HIGH PREVALENCE OF ISLET-CELL ANTIBODY AND DEFECTIVE INSULIN RELEASE IN CHILDREN WITH SCHISTOSOMIASIS

The importance of islet cell antibodies (ICA) as a predictor of insuli n dependent diabetes mellitus (IDDM) has been emphasized by several in vestigators since 1974. The ICA was also detected in patients with var ious immune-mediated diseases such as auto-immune thyroiditis. Schisto somiasis is a wide-spread helminthic disease which affects more than 2 00 million patients all over the world. Immunological abnormalities an d pancreatic affection are features of the disease. We studied the pre valence of ICA in 40 children with schistosomiasis (20 males and 20 fe males), 14 children with IDDM, and 30 of the nondiabetic siblings of p atients with IDDM, and evaluated the oral glucose tolerance and early release of insulin after an i.v. load of glucose in children with schi stosomiasis, diabetics' siblings, and 10 normal age-matched controls. The age of onset of IDDM and duration of the disease were 6.5 +/- 2.3 and 4.1 +/- 1.2, respectively, and the age of onset and duration of sc histosomiasis were 8.3 +/- 2.7 and 2.5 +/- 1.5 years, respectively. Se x, consanguinity, history of previous virus diseases (mumps, measles a nd rubella), and sex maturity rating did not differ among the three st udy groups; however, children with schistosomiasis were significantly older. The prevalence of ICA was 50 per cent in children with IDDM, 13 per cent in the diabetics' siblings, and 25 per cent of children with schistosomiasis. Glucose tolerance was normal in children with schist osomiasis and diabetics' siblings. Early release of insulin after i.v. glucose load was significantly lower in children with schistosomiasis compared to the other two groups. In conclusion, the high prevalence of ICA and the decreased early release of insulin in response to an i. v. glucose load in children with schistosomiasis suggest that auto-imm une aggression against the islet cells contributes in the pathogenesis of pancreatic disease in these patients, and might increase the risk for developing glucose intolerance and diabetes.