Hyperinsulinemic Hypoglycemia After Roux-en-Y Gastric Bypass / 임상당뇨병

Bariatric surgery is one of the most efficient ways to achieve weight loss and reduce the complications associated with obesity. Severe hypoglycemia can occur after bariatric surgery, though it is rare. Hypoglycemic episodes have so far been poorly studied and the pathophysiology of hypoglycemia has not yet been demonstrated. Currently, there are two different hypotheses; the first is that hypoglycemic episodes are secondary to hyperinsulinemia and result from beta-cell hyperplasia or hyperfunction. The second is that the primary problem is beta-cell failure, which allows glucose concentrations to reach high values. The few therapeutic options that have been validated are also discussed in this study.

A Case of Adrenocortical Carcinoma Secreting Cortisol and Aldosterone / 영남의대학술지

Adrenocortical carcinomas are rare and frequently aggressive tumors that may be functional (hormone-secreting) and may cause Cushing's syndrome or virilization, or non-functional and manifest as an abdominal mass. This paper reports the case of a 77-year-old woman with cortisol- and aldosterone-secreting adrenal carcinoma. The patient complained of general weakness, a moon face, and weight gain. She also had hypokalemia and hypertension. Her endocrinological data showed excessive aldosterone production and non-suppressible cortisol production in a low-dose dexamethasone suppresion test. Her abdominal CT showed a right adrenal mass. She underwent right adrenalectomy, and her histology revealed the presence of adrenocortical carcinoma. After adrenalectomy, her hypokalemia returned to normal and she is being treated with hydrocortisone.

The First Case of Abacavir Hypersensitivity Associated with the HLA-B*57:01-Positive Allele in Korea / 감염과화학요법

On the 12th day of abacavir treatment, a 39-year old HIV-infected male patient was admitted with fever, generalized rash, abdominal pain, and watery diarrhea that had persisted for five days. Results of blood tests indicated rapid progression of hepatitis and renal failure. The day after stopping anti-retroviral therapy, his fever subsided and his liver function began to normalize. He was clinically diagnosed with abacavir hypersensitivity and was found to carry the HLA-B*57:01 allele. This is the first reported case of abacavir hypersensitivity associated with the presence of the HLA-B*57:01 allele in Korea.