We present the case of a well characterised M.O.D.Y. type 2 diabetes family in which one of the children associated beta cell autoimmunity and a HLA DQB1 at risk for immune-mediated type 1 diabetes mellitus.
While autoimmunity accounts for at least half of patients with Addison's disease in South Africa and is associated with HLA DQB1*0201, none of the Black Africans or Asians in this cohort had adrenal autoantibodies.
Association with the HLA DQB1*06:02/DQA1*01:02 (98% vs. 25%) heterodimer (DQ0602), T cell receptors (TCR) and other immune loci suggest autoimmunity but autoantigens are unknown.