Cetoacidosis diabética reversible con metotrexato: Resistencia al tratamiento insulínico. Caso clínico / Diabetic ketoacidosis responsive to methotrexate in a patient with a mixed connective tissue disease
Rev. méd. Chile
;
135(1): 87-91, ene. 2007. tab
Artículo
en Español
| LILACS
| ID: lil-442995
ABSTRACT
We report a 42 year-old woman with a hypothyroidism and a mixed connective tissue disease treated with prednisone and methotrexate. The patient had normal blood glucose levels but when the methotrexate dose was tapered, she presented a diabetic ketoacidosis that required up to 520 units of insulin per day. Due to the intensification of the mixed connective tissue disease symptoms, the doses of methotrexate and prednisone were increased again with a simultaneous normalization of serum glucose levels and glucose tolerance. In the following six months, when the dose of methotrexate was tapered again, the hyperglycemia reappeared and was again controlled increasing the dose. Thirty months after the episode of keotacidosis, the patient was with a weekly dose of methotrexate, asymptomatic and with a normal glucose tolerance. Anti insulin antibodies were not detected and anti islet antibodies were indeterminate, due to interference with antinuclear antibodies. It is possible that the episode of ketoacidosis was unveiled by an autoimmune phenomenon.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Resistencia a la Insulina
/
Metotrexato
/
Cetoacidosis Diabética
/
Inmunosupresores
/
Enfermedad Mixta del Tejido Conjuntivo
Tipo de estudio:
Estudio de etiología
Límite:
Adulto
/
Femenino
/
Humanos
Idioma:
Español
Revista:
Rev. méd. Chile
Asunto de la revista:
Medicina
Año:
2007
Tipo del documento:
Artículo
País de afiliación:
Chile
Institución/País de afiliación:
Servicio de Salud Viña del Mar/CL
/
Universidad de Valparaíso/CL
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