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Preeclampsia and diabetes

        To the Editors: Ness and Roberts (Ness RB, Roberts JM. Heterogeneous causes constituting the single syndrome of preeclampsia: A hypothesis and its implications. Am J Obstet Gynecol 1996;175:1365–70) have suggested that the clinical syndrome of preeclampsia has several causes that can be divided into two main groups, the first subtype originating in the placenta and the second subtype originating in the mother from preexisting disease. Theirs is an attractive and plausible viewpoint with which I have much sympathy.
        However, included in the group of maternal disorders alleged to predispose directly to preeclampsia is diabetes mellitus. I recently proposed an explanation for this weak association supported by HLA-DR data.
        • Kilpatrick DC.
        HLA-dependent TNF secretary response may provide and immunogenetic link between pre-eclampsia and type-1 diabetes mellitus.
        In brief, I suggested that preeclampsia and type 1 diabetes share a common immunogenetic susceptibility that correlates with tumor necrosis factor-α responses. My hypothesis is not inconsistent with that of Ness and Roberts and perhaps better accounts for the observation that nondiabetic women who have preeclampsia in pregnancy are at increased risk for insulin-dependent diabetes in later life.
        • Dahlquist G
        • Källén B.
        Maternal-child blood group incompatibility and other perinatal events increase the risk for early-onset type 1 (insulin-dependent) diabetes mellitus.
        D. C. Kilpatrick, Department of Transfusion Medicine, 2 Forrest Road, Edinburgh, United Kingdom EH1
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        References

          • Kilpatrick DC.
          HLA-dependent TNF secretary response may provide and immunogenetic link between pre-eclampsia and type-1 diabetes mellitus.
          Dis Markers. 1996; 13: 43-47
          • Dahlquist G
          • Källén B.
          Maternal-child blood group incompatibility and other perinatal events increase the risk for early-onset type 1 (insulin-dependent) diabetes mellitus.
          Diabetologia. 1992; 35: 671-675