'Snow White and the Seven Dwarfs', a fairytale that is widely known across the Western world, was originally written by the Brothers Grimm, and published in 1812. Though each dwarf was first given an individual name in the 1912 Broadway play by the same title, in Walt Disney's 1937 film 'Snow White and the Seven Dwarfs', they were renamed, and their names have become household words. As it is well known, myths, fables, and fairytales, though appearing to be merely children’s tales about made-up and magical beings and places, have, more often than not, originated from real facts. Therefore, the presence in the story of seven brothers with short stature is, from an endocrinological point of view, highly intriguing, in fact, thrilling. The diversity of the phenotypes among the seven dwarfs is also stimulating , although puzzling. We undertook a differential diagnosis of their common underlying disorder based on the original Disney production drawings and the unique characteristics of these little gentlemen, while we additionally evaluated several causes of short stature and, focusing on endocrine disorders that could lead to these clinical features among siblings, and we have, we believe, been able to reveal the underlying disease depicted in this archetypal tale.
Athanasios Zervas, George Chrousos, and Sarantis Livadas
Stavroula A Paschou, Nektaria Papadopoulou-Marketou, George P Chrousos, and Christina Kanaka-Gantenbein
Type 1 diabetes mellitus (T1DM) results from the autoimmune destruction of β cells of the endocrine pancreas. Pathogenesis of T1DM is different from that of type 2 diabetes mellitus, where both insulin resistance and reduced secretion of insulin by the β cells play a synergistic role. We will present genetic, environmental and immunologic factors that destroy β cells of the endocrine pancreas and lead to insulin deficiency. The process of autoimmune destruction takes place in genetically susceptible individuals under the triggering effect of one or more environmental factors and usually progresses over a period of many months to years, during which period patients are asymptomatic and euglycemic, but positive for relevant autoantibodies. Symptomatic hyperglycemia and frank diabetes occur after a long latency period, which reflects the large percentage of β cells that need to be destroyed before overt diabetes become evident.