ABSTRACT
El síndrome hiperglucémico hiperosmolar no cetósico (SHNC) se ha asociado con diversas alteraciones neurológicas, incluidos los trastornosd el movimiento. Es la segunda causa más frecuente de hemicoreahemibalismo, que se produce como consecuencia de la afectación delputamen contralateral. Presentamos a una paciente de 95 años con un SHNC que desarrolló un hemibalismo secundario a una lesión putaminal (AU)
Non-ketotic hyperglycemia has occasionally been associated with various neurological abnormalities including movement disorders. Hyperglycemichyperosmolar syndrome (HHS) is the second most common cause of hemiballism-hemichorea, which is due to acontralateral putaminal lesion. We describea 95-year-old woman with HHS who developed hemichorea-hemiballism syndrome due to a putaminal lesión (AU)
Subject(s)
Humans , Female , Aged , Dyskinesias/etiology , Hyperglycemic Hyperosmolar Nonketotic Coma/complications , Putaminal Hemorrhage/complications , Tomography, X-Ray ComputedABSTRACT
Non-ketotic hyperglycemia has occasionally been associated with various neurological abnormalities including movement disorders. Hyperglycemic hyperosmolar syndrome (HHS) is the second most common cause of hemiballism-hemichorea, which is due to a contralateral putaminal lesion. We describe a 95-year-old woman with HHS who developed hemichorea-hemiballism syndrome due to a putaminal lesion.
ABSTRACT
La acidosis láctica es un efecto secundario de la metformina poco frecuente, que es más probable que se produzca en pacientes con ciertas condiciones predisponentes. Presentamos el caso de un paciente con hipertensión arterial tratada con indapamida y captopril y diabetes mellitus tipo 2 tratada con insulina y metformina con función renal previa normal, que tras toma de antiinflamatorios no esteroideos presenta cuadro de vómitos, dolor abdominal, diarrea, oliguria y acidosis láctica. En la analítica al ingreso, se objetivó urea a 227 mg/dl, creatinina a 13,2 mg/dl, pH 6,98, bicarbonato a 7,1 mmol/l y ácido láctico a 105,4 mg/dl (normal hasta 19,8 mg/dl). Tras tratamiento con dos sesiones de hemodiálisis, el paciente evoluciona favorablemente, aunque al alta persiste la insuficiencia renal. La acidosis láctica es una seria complicación del tratamiento con metformina que es más frecuente en casos de insuficiencia renal y otros procesos intercurrentes (AU)
Lactic acidosis is an uncommon side effect of metformin use, which is more likely to arise in patients with certain predisposing factors. We present the case of a patient with hypertension treated with indapamide and captopril and type 2 diabetes mellitus treated with insulin and metformin. Previous renal function was normal. After taking non-steroidal anti-inflammatory drugs, the patient developed vomiting, abdominal pain, diarrhea, oliguria, and lactic acidosis. Tests on admission showed urea 227 mg/dl, creatinine 13.2 mg/dl, pH 6.98, bicarbonate 7.1 mmol/l, and lactic acid 105.4 mg/dl (normal below 19.8 mg/dl). After two hemodialysis sessions, the patient improved, although kidney failure persisted after discharge. Lactic acidosis is a serious complication of metformin therapy and is more frequent in patients with kidney failure and other intercurrent complaints (AU)