The Pathology of the Endocrine Pancreas in Diabetes
Diabetes mellitus represents one of the most frequent and serious clinical syn dromes in contemporary medicine. Since the end of the nineteenth century, the endocrine pancreas has been implicated in the pathogenesis of this disease. Several pathologists
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to whom this Book is dedicated at the Occasion of his Retirement from Academic Life
P.J. Lefebvre
D. G. Pipeleers (Eds.)
The Pathology of the Endocrine Pancreas in Diabetes With 72 Figures
Springer-Verlag Berlin Heidelberg New York London Paris Tokyo
Professor Dr. Pierre J. Lefebvre Division of Diabetes, Nutrition and Metabolic Disorders Department of Medicine Centre Hospitalier Universitaire du Sart-Tilman B-4000 Liege 1, Belgium Professor Dr. Daniel G. Pipeleers Dept. of Metabolism and Endocrinology Vrije Universiteit Brussel Laarbeeklaan 103 B-1090 Brussels, Belgium
Library of Congress Cataioging-in-Publication Data The Pathology of the endocrine pancreas in diabetes P.). Lefebvre, D. G. Pipeleers (eds.l TSBN-13: 978-3-642-72693-4 e-TSBN-13 978-3-642-72691-0 DOT 10.1007/978-3-642-72691-0 1. Diabetes-Pathophysiology. 2. Islands of Langerhans-Pathophysiology. I. Lefebvre, P.). (Pierre )1 II. Pipeleers, D.G. (Daniel G'), IDNLM: 1. Diabetes Mellitus-complications. 2.lslands of Langerhans-physiopathology. WK 835 P29751 RC660.P325 1988 616.4'6207-dc19 DNLM/DLC for Library of Congress This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, re-use of illustrations, recitation, broadcasting, reproduction on microfilms or in other ways, and storage in data banks. Duplication of this publication or parts thereof is only permitted under the provisions of the German Copyright Law of September 9, 1965, in its version of June 24, 1985, and a copyright fee must always be paid. Violations fall under the prosecution act of the German Copyright Law.
© Springer-Verlag Berlin Heidelberg 1988 Softcover reprint of the hardcover 1sedition 1988 The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. 2127/3145-543210
Preface
Diabetes mellitus represents one of the most frequent and serious clinical syndromes in contemporary medicine. Since the end of the nineteenth century, the endocrine pancreas has been implicated in the pathogenesis of this disease. Several pathologists of the twentieth century detected various lesions and morphologic alterations in the pancreatic islets of diabetic patients, but the pathophysiologic basis of their findings remained long obscure. The systematic microscopic work of WILLY GEPTS clarified the views and related the variety in histopathology to differences in origin, duration and clinical expression of the disease. Over the past two decades, the concept of a multifactorial origin of diabetes has become widely accepted. Various agents and mechanisms have been identified which can lead to a quantitative or qualitative deficit in pancreatic B-cells. The purpose of this book is to bring an update on the many pathways which may induce an absolute or relative insufficiency in insulin release and hence a diabet