Fulminant type 1 diabetes after allogeneic bone marrow transplantation for follicular lymphoma

A 61-year-old man with refractory follicular lymphoma was treated with allogeneic bone marrow transplantation in July 2010. On day 121 after transplantation, when he was receiving cyclosporine and prednisolone as a treatment for graft-versus-host disease, he displayed a poor appetite and epigastralgia. Due to his elevated serum amylase and C-reactive protein levels, he was re-admitted on day 123 after transplantation. His course was complicated by fulminant type 1 diabetes on day 133, which required intensive insulin therapy. In addition, cytomegalovirus reactivation was observed at the onset of fulminant type 1 diabetes. In this case, both the donor and recipient displayed the following human leukocyte antigen haplotype: DRB1 (0101, 0901), DQB1 (0303, 0501). This is the first case report of fulminant type 1 diabetes after allogeneic hematopoietic stem cell transplantation.