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1.
Yonsei Med J ; 54(5): 1289-92, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23918584

RESUMO

We describe herein a case of life-threatening hypoglycemia due to spurious elevation of glucose concentration during the administration of ascorbic acid in a type 2 diabetic patient. A 31-year-old female was admitted for proliferative diabetic retinopathy treatment and prescribed high dose ascorbic acid. During hospitalization, she suddenly lost her consciousness and her glucose concentration was 291 mg/dL, measured using self-monitoring blood glucose (SMBG) device, while venous blood glucose concentration was 12 mg/dL. After intravenous injection of 50% glucose solution, the patient became alert. We reasoned that glucose measurement by SMBG device was interfered by ascorbic acid. Physicians should be aware of this interference; high dose ascorbic acid may cause spurious elevation of glucose concentration when measuring with SMBG devices.


Assuntos
Ácido Ascórbico/uso terapêutico , Hipoglicemia/diagnóstico , Adulto , Ácido Ascórbico/administração & dosagem , Ácido Ascórbico/efeitos adversos , Glicemia , Automonitorização da Glicemia/instrumentação , Automonitorização da Glicemia/normas , Contraindicações , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/tratamento farmacológico , Feminino , Humanos , Diálise Renal
2.
Endocrinol Metab (Seoul) ; 28(3): 231-5, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24396684

RESUMO

Primary hyperparathyroidism occurs as a result of isolated parathyroid adenoma in 80% to 85% of all cases. A (99m)technetium ((99m)Tc) sestamibi scan or neck ultrasonography is used to localize the neoplasm prior to surgical intervention. A 53-year-old female was referred for the exclusion of metabolic bone disease. She presented with low back pain that had persisted for the past 6 months and elevated serum alkaline phosphatase (1,253 IU/L). Four years previously, she had been diagnosed at a local hospital with a 2.3-cm thyroid nodule, which was determined to be pathologically benign. Radiofrequency ablation was performed at the same hospital because the nodule was still growing during the follow-up period 2 years before the visit to our hospital, and the procedure was unsuccessful in reducing the size of the nodule. The results of the laboratory tests in our hospital were as follows: serum calcium, 14.6 mg/dL; phosphorus, 3.5 mg/dL; and intact parathyroid hormone (iPTH), 1,911 pg/mL. Neck ultrasonography and (99m)Tc sestamibi scan detected a 5-cm parathyroid neoplasm in the left lower lobe of the patient's thyroid; left parathyroidectomy was performed. This case indicated that thyroid ultrasonographers and pathologists need to be experienced enough to differentiate a parathyroid neoplasm from a thyroid nodule; (99m)Tc sestamibi scan, serum calcium, and iPTH levels can help to establish the diagnosis of parathyroid neoplasm.

3.
Intern Med ; 51(17): 2361-3, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22975549

RESUMO

A 23-year-old pregnant woman had a stillbirth at 30 weeks gestation due to abrupt diabetic ketoacidosis. The patient had a normal HbA1c, severe hyperglycemia, negative islet cell autoantibodies, and very low insulin secretion capacity. The viral markers associated with fulminant type 1 diabetes were negative. The patient's human leukocyte antigen genotypes were DRB1*04:06 and DQB1*03:01/05:02, not common subtypes for fulminant type 1 diabetes. This is the first Vietnamese patient with fulminant type 1 diabetes mellitus.


Assuntos
Povo Asiático/genética , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/genética , Diabetes Mellitus Tipo 1/imunologia , Cetoacidose Diabética/complicações , Feminino , Cadeias beta de HLA-DQ/genética , Cadeias HLA-DRB1/genética , Humanos , Gravidez , Complicações na Gravidez , Natimorto , Adulto Jovem
4.
Int J Hematol ; 92(4): 651-4, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20967517

RESUMO

A 61-year-old man was diagnosed with the simultaneous occurrence of chronic myeloid leukemia (CML) and infiltrative intrathoracic plasmacytoma, radiologically mimicking bronchogenic carcinoma. Following the administration of imatinib mesylate (IM; 400 mg/day), both hematologic and partial cytogenetic remission of CML were achieved. However, the pulmonary plasmacytoma was persistently aggravated. High-dose dexamethasone was added to the IM therapy because the patient refused radiotherapy to control the aggravated pulmonary plasmacytoma. Finally, he died due to pneumonia and multi-organ failure during concurrent administration of IM and high-dose dexamethasone.


Assuntos
Leucemia Mieloide de Fase Crônica/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Plasmocitoma/diagnóstico , Neoplasias Torácicas/diagnóstico , Carcinoma Broncogênico/diagnóstico , Diagnóstico Diferencial , Evolução Fatal , Humanos , Leucemia Mieloide de Fase Crônica/tratamento farmacológico , Neoplasias Pulmonares/diagnóstico , Masculino , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/tratamento farmacológico , Plasmocitoma/tratamento farmacológico , Neoplasias Torácicas/tratamento farmacológico
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