“Diabetic Mastopathy,” or Sclerosing Lymphocytic Lobulitis, Is Strongly Associated With Type 1 Diabetes

• Published in: Diabetes care Vol. 25; no. 1; pp. 121 - 126
• Main Authors: Kudva, Yogish C., Reynolds, Carol, O’Brien, Timothy, Powell, Claudia, Oberg, Ann L., Crotty, Thomas B.
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.01.2002
• Subjects: Adult; Age of Onset; B-Lymphocytes - pathology; Biological and medical sciences; Breast diseases; Breast Diseases - blood; Breast Diseases - complications; Breast Diseases - pathology; Cross-Sectional Studies; Diabetes; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - pathology; Diabetes Mellitus, Type 2 - physiopathology; Diabetes. Impaired glucose tolerance; Disease Progression; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Glycated Hemoglobin A - analysis; Health aspects; Humans; Lymphocytes - pathology; Medical sciences; Middle Aged; Ophthalmology; Pilot Projects; Retinopathies; Retrospective Studies; Risk Factors; Thyroiditis, Autoimmune - complications; Type 1 diabetes; Type 2 diabetes; United States; Endocrinopathy; Prevalence; Retinopathy; Autoimmune disease; Peripheral neuropathy; Non insulin dependent diabetes; Epidemiology; Strong; Age of onset; Lymphoproliferative syndrome; Surgery; Cross sectional study; Peripheral nerve disease; Diagnosis; Parity; Kidney disease; Human; Immunopathology; Nervous system diseases; Urinary system disease; Thyroid diseases; Malignant hemopathy; Eye disease; Nephropathy; Biopsy; Risk factor; Insulin dependent diabetes; Breast
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.25.1.121

“Diabetic Mastopathy,” or Sclerosing Lymphocytic Lobulitis, Is Strongly Associated With Type 1 Diabetes Yogish C. Kudva , MD 1 , Carol Reynolds , MD 2 , Timothy O’Brien , MD 1 , Claudia Powell , MS 3 , Ann L. Oberg , PHD 3 and Thomas B. Crotty , MD 4 1 Division of Endocrinology and Metabolism, Mayo Clinic, Rochester, Minnesota 2 Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota 3 Division of Biostatistics, Mayo Clinic, Rochester, Minnesota 4 Division of Anatomic Pathology, St. Vincent’s Hospital, Dublin, Ireland Abstract OBJECTIVE —To demonstrate the strong association of diabetic mastopathy or sclerosing lymphocytic lobulitis with type 1 diabetes mellitus by studying appropriate control groups and to describe risk factors and natural history of the disorder. RESEARCH DESIGN AND METHODS —This was a retrospective cross-sectional study of four groups of patients conducted at a setting tertiary care medical center. We examined benign breast biopsies (investigator masked to identity) from age-matched patients with types 1 and 2 diabetes, autoimmune thyroid disease, or none of the above disorders for sclerosing lymphocytic lobulitis. Several risk factors proposed for the disorder (age at diagnosis of benign breast disease, duration of diabetes, age at onset of diabetes, prevalence of retinopathy, neuropathy, nephropathy and cheiroarthropathy, glycemic control, parity, oral contraceptive use, menopausal status, or number of breast biopsies) were evaluated, and patients were contacted to describe the natural history of the disorder. RESULTS —Sclerosing lymphocytic lobulitis was identified in 69.7% of the subjects with type 1 diabetes and 1.8% of those with autoimmune thyroid disease diagnosed with benign breast disease at surgery. It did not occur in patients with type 2 diabetes with or without insulin treatment or in control subjects. Only retinopathy and peripheral neuropathy were associated with sclerosing lymphocytic lobulitis. Breast carcinoma or lymphoma did not occur subsequently in any type 1 diabetes patient with or without sclerosing lymphocytic lobulitis. CONCLUSIONS —Sclerosing lymphocytic lobulitis is strongly associated with type 1 diabetes. Retinopathy and neuropathy are associated with the disorder. The risk of malignancy is not increased. IRB, institutional review board RDNS, Rochester Diabetic Neuropathy Study Footnotes Address correspondence and reprint requests to Yogish C. Kudva, M.D., Division of Endocrinology and Metabolism, Mayo Clinic, Rochester, MN 55905-0001. E-mail: kudva.yogish{at}mayo.edu . Received for publication 12 September 2001 and accepted in revised form 27 September 2001. A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.