[Myocarditis and insulitis following coxsackie virus infection]

Abstract

We report on the case of a 5 7/12-year-old girl, who presented an acute insulin-dependent diabetes mellitus nineteen days after the operative suture of an atrial septum defect, and who died in a hyperosmolar coma diabeticum in spite of an intensive therapy. At the autopsy there was shown a myocarditis with the histological characteristics of a virus infection. The islet tissue of the pancreas was largely necrotic, the great majority of the islets of Langerhans presented lymphocytic infiltrates. In a neutralisation test against coxsackie-B-viruses (CBV), which was conducted after death, there was found among others an antibody titer of 1:192 against CBV-4. With FITC-marked CBV-antiglobulin, in the islet tissue intracellular CBV-antigen could be proved. It is discussed that virus infections have an etiological importance for the incidence of a so-called juvenile diabetes in man.