GVHD in its sclerodermiform form revealing type 1 diabetes: A case report
Department of Endocrinology, Diabetes, Metabolic Diseases and Nutrition, Mohammed VI University Hospital, Marrakech, Morocco.
Case Study
World Journal of Advanced Research and Reviews, 2023, 18(01), 211–213
Article DOI: 10.30574/wjarr.2023.18.1.0573
Publication history:
Received on 25 February 2023; revised on 04 April 2023; accepted on 07 April 2023
Abstract:
Sclerodermiform syndrome is Common in diabetic, it encompasses a set of manifestations that preferentially affect the hands and back, but the association of type 1 diabetes with systemic sclerosis is a rare entity. We report the case of 18-year-old patient from a consanguineous marriage, with a history of acute myeloid leukemia which he was treated by an allograft in France associated with chemotherapy 9 session and immunosuppressants currently in complete remission, diabetic type 1 for 4 years, hypothyroidism under levothyrox 50ug / d. At the interrogation the patient reported the consequences of the graft were marked by stage I cutaneous GVHD confirmed by skin biopsy of which he received corticosteroid therapy at a dose of 10mg / day in addition to neoral or slightly atrophic hyperpigmented macules not sclerotic at the level of the back and the lateral surface of the left foot. The patient also had corticosteroid-induced complications, including diabetes and osteoporosis. On physical examination tendon retraction, elbows and finger, Amyotrophy of the hands, palpable thyroid not increased volume allowed for glycemic imbalance. At TSH biology = 6uui / ml, HBA1C = 8%, anti-GAD antibody negative to cervical ultrasound: thyroid hypotrophy with thyroid nodules classified EUTIRADS 2. The patient is referred for follow-up in dermatology.
The association of sweet diabetes and sclerodermiform lesions is frequently linked to the glycemic imbalance responsible for an accumulation of extracellar matrix and excessive glycation of collagen.
The search for signs of scleroderma should be evoked in front of a diabetic hand syndrome to Watch for and treat associated pathologies.
Keywords:
GVHD; Sclerodermiform; Type 1 diabetes; Corticosteroid; Myeloid leukemia
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Copyright © 2023 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0