Case study of a patient with diabetes mellitus and granulomatosis
DOI: 10.32364/2225-2282-2026-3-7
Case study of a patient with diabetes mellitus and granulomatosis
N.I. Volkova, I.Yu. Davidenko, E.V. Voronina, V.E. Shpakova
Varvara E. Shpakova, e-mail: shikimopskek@gmail.com
Rostov State Medical University, Rostov-on-Don
Сontemporary clinical practice is witnessing a steady rise in autoimmune pathologies, which commonly involve multi-organ damage and lead to prolonged patient disability. Of particular interest are cases of polyautoimmunity concerning the coexistence of multiple immune-mediated diseases in a single patient. These combinations not only complicate the clinical presentation but also pose significant therapeutic challenges, requiring a profound understanding of interrelated pathogenetic mechanisms. The association between type 1 diabetes mellitus (DM1) and granulomatosis with polyangiitis (GPA) serves as a prominent example of such a complex clinical issue. Both disorders are immune-inflammatory in nature: DM1 is driven by T-cell-mediated destruction of pancreatic β-cells, while GPA is an ANCA-associated (anti-neutrophil cytoplasmic antibodies) systemic vasculitis characterized by granulomatous inflammation primarily affecting the respiratory tract and kidneys. The theoretical framework for their coexistence includes shared mechanisms of immune tolerance loss, chronic systemic inflammation in DM1, and the potential role of molecular mimicry, where an infectious trigger initiates a cross-reactive immune response against a background of existing autoimmune dysregulation. This case study illustrates the practical aspects of diagnosis and management of patients with this combined autoimmune syndrome, emphasizing the necessity of a multidisciplinary approach.
Keywords: autoimmune diseases, type 1 diabetes mellitus, granulomatosis with polyangiitis, Wegener’s granulomatosis, glucocorticosteroids, insulin therapy, immunosuppression, ANCA-associated vasculitis, underweight, polyautoimmunity.
For citation: Volkova N.I., Davidenko I.Yu., Voronina E.V., Shpakova V.E. Case study of a patient with diabetes mellitus and granulomatosis. RMJ. 2026;3:42–46. DOI: 10.32364/2225-2282-2026-3-7
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