Cell infiltrations in the pancreas of newborn infants of diabetic mothers

Endocrine pancreas in the postnatal offspring of alloxan diabetic rats

This study was conducted to investigate the morphological changes in the postnatal pancreatic islets in offspring of diabetic rats. Diabetes was induced in female Sprague Dawley rats by intravenous injection of alloxan (40 mg/kg). After 1 week, rats with blood sugar above 270 mg% were bred and watched until spontaneous delivery occurred. Litters in the following age groups were sacrificed by decapitation, 0, 8, 24, 72 and 168 h, and compared with their controls. Blood sugar levels were significantly higher in the neonates of diabetic mothers immediately after delivery compared to the control, then became normal after 8 h. Islets of the offspring of the diabetics at birth showed weak positive staining for insulin using immunocytochemical techniques. By 72 h some cells showed immunopositive staining similar to the control, while at 168 h all the beta (B) cells were stained normally. Beta cells of the islets from the diabetic series at birth were almost completely degranulated except for scattered granules toward the periphery. Their cytoplasm exhibited glycogen and lipid accumulations. Cells also showed signs of hyperfunction in the form of an extensive endoplasmic reticulum and well-developed Golgi complex with distended Golgi cisternae. At 8 h postnatally the population of pale secretory granules was markedly increased. The changes described at birth persisted at 24 h and, to a lesser extent, 72 h after delivery. At the age of 1 week, the beta cells appeared to be normal.

Disseminated eosinophilic infiltration of a newborn infant, with perforation of the terminal ileum and bile duct obstruction

A preterm boy died 4 days after delivery from septicaemia which at necropsy was found to be due to perforation of an eosinophilic lesion of the terminal ileum. Eosinophilic infiltration was also found in kidney, lymph node, bone marrow, portal tracts of liver, gall bladder, and bile duct with associated obstruction of the cystic duct and mucocele of the gall bladder. No allergic cause for the infiltrate was found in either the infant or his mother. Eosinophilic infiltration of neonatal spleen, lymph node, intestinal mucosa, epicardium, thymus, pancreas, portal tracts of the liver, and skin has been reported but the aggressive behaviour of the infiltrate in this patient bears more resemblance to the eosinophilic gastroenteritis that has been described in older children and adults.

Eosinophilic pancreatitis in the newborn infant of a diabetic mother

The authors have studied the pancreas of a premature female infant born to a diabetic mother. The findings included a peri-insular eosinophilic leucocyte infiltration, macropolinesia and a marked increase in B cells. In the exocrime parenchyma small B cells aggregates were also observed. B cells contained voluminous hypercromatic muclei and degranulated cytoplasm. Morphometric data demonstrated an increase in islet tissue. These morphological findings are indicative of excessive insulin secretion. The presence of eosinophilic leucocytes in pancreatic tissue and the pathogenic mechanism involved are discussed.

Pancreatic-islet fibrosis in young infants of diabetic mothers

Pancreatic-islet fibrosis was found at necropsy in six out of ten infants (aged 11-142 days) born to diabetic mothers. Fibrosis covered an islet area of 5-10% in three cases, 10-20% in two cases, and more than 20% in one case. The three infants with the most pronounced islet fibrosis were heavier than normal at birth, and at least two of them were of "diabetic appearance" at birth. Five of the six cases with islet fibrosis had major malformations.