Simultaneous onset of type 1 diabetes mellitus and painless thyroiditis following acute pancreatitis

A 24-year-old female suffered from acute pancreatitis, followed by simultan eous onset of painless goiter, elevation of thyroid hormones and diabetic k etoacidosis, Two months later, her insulin secreting function was severely decreased and positive for anti-GAD and anti-islet cell antibodies, whereas the serum glucagon level was normal, suggesting an autoimmune-related dest ruction specifically of beta cells. In addition, the initial hyperthyroid s tate was followed by a hypothyroid phase which later recovered to an euthyr oid state, suggesting an initial destruction of thyroid cells. Because anti -thyroidal antibodies were positive, it is likely that the thyroidal destru ction was also autoimmune-related. This case implies common pathogenic mech anisms in the autoimmunity related destruction of beta cells and thyroid ce lls.