A case of hyperthyroidism presented as diabetic ketoacidosis / 대한내과학회지

Diabetic ketoacidosis is an acute complication of diabetic mellitus. The most common triggering factors are infection, insulin therapy omission and the onset of the disease, but if these are excluded, other less frequent etiologic factors must be ruled out. We report a case of 22-year-old woman with Graves' disease presented as diabetic ketoacidosis. She was diagnosed type 1 diabetes mellitus at 13 years old and continually has been treated with insulin therapy until now. She typically showed tachycardia at rest in spite of correction of metabolic acidosis. Hyperthyroidism worsens glycemic control in diabetic patients and may precipitate diabetic ketoacidosis. Hyperthyroidism always should be investigated in diabetic patients presenting diabetic ketoacidosis without obvious triggering factors.

A case of pseudo-Cushing's syndrome with unilateral nonfunctioning adrenal adenoma / 대한내과학회지

A pseudo-Cushing's state can be defined as some or all of the clinical features of Cushing's syndrome together with some evidence for hypercortisolism. It may be related to depression, alcohol abuse and obesity. Its manifestation may be transient and resolved with abstinence from causing factors. We report a case of a 70-year-old woman with unilateral nonfunctioning adrenal adenoma and geriatric depressive disorder, which diagnosed by Geriatric Depression Scale (GDS). She showed clinical and/or biochemical features of Cushing's syndrome. Low dose and high dose dexamethasone suppression tests were not identical to those in ACTH independent Cushing's syndrome. Few cases of pseudo-Cushing's syndrome were reported previously in Korea but there was no report about pseudo-Cushing's syndrome combined with nonfunctional adrenal adenoma.