Published in:
01-02-2009 | Letter
Congenital rubella: citation virus or viral cause of type 1 diabetes? Reply to Honeyman MC, Harrison LC [letter] and Burgess MA, Forrest JM [letter]
Author:
E. A. M. Gale
Published in:
Diabetologia
|
Issue 2/2009
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Excerpt
I thank these correspondents [
1,
2] for their interest in my Editorial [
3]. Drs Burgess (née Menser) and Forrest [
1] chide me gently for missing two references, and I was certainly unaware of the book chapter cited [
4]. The other reference [
5] relates mainly to an experimental model of teratogenicity in animals, but does indeed contain a table listing eight Australian patients with congenital rubella who developed diabetes between the ages of 18 months and 33 years, all of whom required insulin. Unfortunately, the clinical information provided is minimal, and I was also concerned about the possibility of double-counting individuals reported in previous series. Drs Honeyman and Harrison [
2] point out that I did not cite the HLA data reported in a letter to the Lancet in 1974 supporting the case for an HLA association linking congenital rubella to type 1 diabetes [
6]. This letter describes HLA serotyping in 87 people with the rubella syndrome, eight of whom had a clinical diagnosis of diabetes, and four of whom were on insulin, plus ten who were said to have ‘latent’ diabetes on glucose tolerance testing. Nine of the 19, including three of those on insulin, had HLA A8. I acknowledge these findings, but remain unconvinced that they add much to the evidence provided in the New York series. …