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Case Reports in EndocrinologyVolume 2012 2012, Article ID 657156, 4 pages

Case ReportDepartment of Internal Medicine, Toyama Prefectural Central Hospital, 2-2-78 Nishinagae, Toyama 930-8550, Japan

Received 17 October 2012; Accepted 2 December 2012

Academic Editors: E. Hershkovitz and R. Swaminathan

Copyright © 2012 Toshio Kahara et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A 71-year-old man with diabetes mellitus visited our hospital with complaints of anorexia and weight loss 12 kg-3 months. He had megaloblastic anemia, cobalamin level was low, and autoantibody to intrinsic factor was positive. He was treated with intramuscular cyanocobalamin, and he was able to consume meals. GAD autoantibody and ICA were positive, and he was diagnosed with slowly progressive type 1 diabetes mellitus SPIDDM. Thyroid autoantibodies were positive. According to these findings, he was diagnosed with autoimmune polyglandular syndrome type 3 with SPIDDM, pernicious anemia, and Hashimoto-s thyroiditis. Extended periods of cobalamin deficiency can cause serious complications such as ataxia and dementia, and these complications may not be reversible if replacement therapy with cobalamin is delayed. Although type 1 diabetes mellitus with coexisting pernicious anemia is very rare in Japan, physicians should consider the possibility of pernicious anemia when patients with diabetes mellitus have cryptogenic anorexia with the finding of significant macrocytosis MCV > 100 fL.

Autor: Toshio Kahara, Hitomi Wakakuri, Juri Takatsuji, Iori Motoo, Kosuke R. Shima, Kazuhide Ishikura, Rika Usuda, and Yatsugi Nod



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