PMC8497828_01
Family pedigree of patients A and B.
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Multiple members of the maternal family had DM ( Figure 1 ). On subsequent follow-up at the age of 4.5 years, the patient's height was 85 cm (-4.5 SDS), and growth velocity (GV) was suboptimal (2.5 cm/year, -3.1 SDS). rhGH therapy was deferred to a later age due to the risk of insulin resistance and the significant family history of DM ( Figure 1 ).
PMC8497828_02
Pancreatic MRI scan of the index patient (patient A) and control patient. The MRI scan in (A, B) showing a small atrophic pancreas of the index patient (patient A). Images clearly show global parenchymal atrophy of the pancreas. The pancreatic parenchyma appears thin with heterogeneous low T1 signals, indicating fibrosis. The MRI scan in (C, D) are axial T2 weighted MRI images of a control case, a 26-year-old male with type 1 DM. The images (C, D) show a normal volume of the pancreas.
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MRI of the pancreas revealed a small, shrunken, and atrophic pancreas, with signs of fibrosis at the age of 18 years ( Figure 2 ).
PMC8497828_03