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August 22, 1977

Viral Disease and Islet Cell Dysfunction

Author Affiliations

William H. Donnelly University of Florida College of Medicine Gainesville

JAMA. 1977;238(8):853-854. doi:10.1001/jama.1977.03280090017005

To the Editor.—  Recent focus has been given to the concept that certain viral diseases may be causally related to islet cell dysfunction of the pancreas.1-2 The experimental work of Craighead3 and Muntefering4 has demonstrated the existence of preferential viral receptor sites for variants of encephalomyocarditis virus on B cells, as opposed to acinar or ductal cells of the pancreas. Isolated observations in man have suggested that such a postulate might be functional in certain instances of congenital rubella infections.5-6 Nevertheless, there has been no evidence in man that pancreatic involvement could be so extensive as to possibly impair future function.At the University of Florida, a 4-month-old girl with documented combined immune deficiency died of severe necrotizing bacterial pneumonia and Pneumocystis carinii interstitial pneumonia. In addition to severe thymic dysplasia (0.7 g), abnormal lymph nodes, and hypoplastic bone marrow, at necropsy she had massive generalized