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Pancreatic Eosinophilic Infiltrates of Infants of Diabetic Mothers Revisited

Randall Craver1

  • 1Laboratory, Children's Hospital of New Orleans, Department of Pathology, Louisiana State University Health Sciences Center, New Orleans, LA, USA.

Fetal and Pediatric Pathology
|December 11, 2024
PubMed

Insights

Infants of diabetic mothers (IDM) may develop pancreatic eosinophilic infiltrates around islets, even before birth. This finding, observed in two cases, suggests a specific inflammatory response in IDM that warrants further investigation.

Area of Science:

  • Pediatric Pathology
  • Endocrinology
  • Neonatology

Background:

  • Infants of diabetic mothers (IDM) commonly exhibit pancreatic eosinophilic infiltrates near islets.
  • This study examines two IDM cases, detailing pancreatic histology and reviewing existing literature.

Purpose of the Study:

  • To describe the pancreatic histology in two infants of diabetic mothers.
  • To review the literature on eosinophilic infiltrates in IDM.

Main Methods:

  • Histopathological examination of pancreatic tissue from two deceased infants of diabetic mothers.
  • Literature review of antenatal and neonatal pancreatic findings in IDM.

Main Results:

  • Both cases showed eosinophilic infiltrates and Charcot Leyden crystals surrounding primary islets.
  • The infiltrate spared pancreatic acini and intralobular islet tissue, with no necrosis, fibrosis, or vasculitis.
  • Literature indicates these infiltrates can occur as early as 28 weeks gestation, sometimes with peri-islet fibrosis.

Conclusions:

  • The eosinophilic infiltrate in IDM occurs antenatally, surrounds primary islets, spares intralobular islet cells, and persists postnatally.
  • This infiltrate is not consistently linked to islet or peri-islet injury.
  • Further research into eosinophil roles in pancreatic inflammation may clarify maternal diabetes effects on infants.

Keywords:
Charcot-Leyden crystalsEosinophilsinfants of diabetic motherspancreas

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