RESUMO
The present article demonstrates an unusual case of type 1 autoimmune pancreatitis (AIP), focusing on the cause of deterioration in glycemic control and weight loss in a patient with pre-existing type 2 diabetes mellitus (DM). A 67-year-old man was diagnosed with type 2 DM 23 years prior and presented with weight loss of approximately 6 kg over a period of 3 months and hemoglobin A1c (HbA1c) of 9.1%. His carbohydrate antigen 19-9 (CA 19-9) level was elevated to 158.54 U/mL (normal, 0~37 U/mL). Considering these findings, we needed to rule out hidden malignancy. Computed tomography of the abdomen showed diffuse swelling of the pancreas uncinated process. The serum immunoglobulin G (IgG) level was elevated to 2,418 mg/dL (normal, 700~1,600 mg/dL), and IgG4 level was elevated to 1,115.0 mg/dL (normal range, 3.9~86.4 mg/dL). This case highlights that AIP should be considered as a cause of significant weight loss and a deterioration in glycemic control in patients with DM. Furthermore, a pancreatic imaging study should be considered in clinical practice to differentiate pancreatic cancer and AIP.
RESUMO
The present article demonstrates an unusual case of bilateral lower extremity edema caused by neurogenic areflexic bladder as the first physical symptom of diabetes. A 52-year-old man presented to the emergency department because of massive edema of his lower limbs. The edema had been present for 2 weeks, was symmetrical, and was progressively covering the lower limbs up to the inguinal area, scrotal bag, and penis and was accompanied by dysuria and an interrupted urine stream. Laboratory findings revealed a serum glucose level of 657 mg/dL and glycated hemoglobin (HbA1c) level of 15.6%. Computed tomography (CT) of the abdomen and pelvis revealed marked enlargement of the bladder with bilateral hydronephrosis and hydroureter. In addition, CT demonstrated bilateral compression of the iliac veins caused by the enlarged bladder. This case highlights the importance of a broad differential diagnosis for patients with diabetes and extensive peripheral edema. Neurogenic bladder should be considered in the differential diagnosis, even in newly diagnosed diabetic patients.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Abdome , Glicemia , Complicações do Diabetes , Diabetes Mellitus Tipo 2 , Diagnóstico Diferencial , Disuria , Edema , Serviço Hospitalar de Emergência , Hemoglobinas Glicadas , Hidronefrose , Veia Ilíaca , Extremidade Inferior , Pelve , Pênis , Rios , Bexiga Urinária , Bexiga Urinaria NeurogênicaRESUMO
No abstract available.
Assuntos
Humanos , Hiperparatireoidismo Primário , Neoplasias das Paratireoides , Esquizofrenia , Glândula Tireoide , Neoplasias da Glândula TireoideRESUMO
Medullary thyroid carcinomas (MTC) are rare tumors that account for approximately 5-10% of all thyroid malignancy in the West. The reported incidence of MTC is less than 5% in Korea. Its prognosis is relatively good with a 15-year survival rate of 64-84%. The incidence of thyroid cancer has been increasing rapidly worldwide and the overall survival of patients with thyroid cancer is excellent. The occurrence of second primary malignancy (SPM) among survivors of thyroid cancer is a concern, together with life expectancy. Recent studies reported a 6-45% increase in the risk of developing SPM after the diagnosis thyroid cancer. We reported a patient with prostate and colon cancer that were diagnosed 10 years after the diagnosis of medullary thyroid carcinoma.
Assuntos
Idoso , Humanos , Neoplasias do Colo , Diagnóstico , Incidência , Coreia (Geográfico) , Expectativa de Vida , Prognóstico , Próstata , Neoplasias da Próstata , Taxa de Sobrevida , Sobreviventes , Glândula Tireoide , Neoplasias da Glândula TireoideRESUMO
Few studies have examined the clinical features and long-term outcomes of isolated pituitary hormone deficiencies after traumatic brain injury (TBI). Such deficiencies typically present at time intervals after TBI, especially after mild injuries such as concussions, which makes their diagnosis difficult without careful history taking. It is necessary to improve diagnosis and prevent life threatening or morbid conditions such as those that may occur in deficiencies of adrenocorticotropic hormone (ACTH) or thyroid-stimulating hormone (as known as thyrotropin, TSH), the two most important pituitary hormones in hypopituitarism treatment. Here, we report two cases of isolated ACTH deficiency and one case of isolated TSH deficiency. These patients presented at different time points after concussion and underwent long-term follow-ups.
Assuntos
Humanos , Hormônio Adrenocorticotrópico , Lesões Encefálicas , Diagnóstico , Seguimentos , Hipopituitarismo , Hormônios Hipofisários , TireotropinaRESUMO
Diabetes mellitus is a common disorder and presents in different ways. Shoulder pain is a common musculoskeletal complaint, especially in middle-aged or older-aged men. While it is widely accepted that diabetics have an increased propensity to develop infections, a diagnosis of osteomyelitis of the humerus as the etiology of constant shoulder pain might be delayed, as occurred in this case study, until patients' develop clear signs of infection. Here, we describe a case of subacute osteomyelitis as the first physical symptom of diabetes; the possibility of osteomyelitis should therefore be investigated in all patients with diabetes mellitus who develop joint or bone-related pain.
Assuntos
Humanos , Masculino , Diabetes Mellitus , Diagnóstico , Úmero , Articulações , Osteomielite , Dor de OmbroRESUMO
No abstract available.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Administração Tópica , Anestesia Epidural , Capsaicina/administração & dosagem , Nefropatias Diabéticas/tratamento farmacológico , Bloqueio Nervoso , Fármacos do Sistema Sensorial/administração & dosagem , Creme para a PeleRESUMO
No abstract available.