RESUMO
A 34-year-old man with a history of rectal cancer was receiving oral chemotherapy [tegafur-uracil (UFT) with leucovorin]. He visited our hospital due to nausea and abdominal pain, and his laboratory data revealed the presence of urinary ketones, hyperglycemia and high anion gap metabolic acidosis, and HbA1c level of 6.8%. Accordingly, we diagnosed fulminant type 1 diabetes. The development of fulminant type 1 diabetes during chemotherapy for malignancy is a rare, but potentially fatal condition. Therefore, clinicians should consider diabetic ketoacidosis in the differential diagnosis when examining chemotherapy patients who present with gastrointestinal symptoms.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Diabetes Mellitus Tipo 1/induzido quimicamente , Cetoacidose Diabética/induzido quimicamente , Neoplasias Retais/tratamento farmacológico , Adulto , Diagnóstico Diferencial , Humanos , Hiperglicemia/induzido quimicamente , Hiperglicemia/tratamento farmacológico , Leucovorina/administração & dosagem , Leucovorina/efeitos adversos , Masculino , Tegafur/administração & dosagem , Tegafur/efeitos adversos , Uracila/administração & dosagem , Uracila/efeitos adversosRESUMO
A 24-year-old healthy woman presented at our hospital due to hypoglycemia. A fasting test provoked spontaneous hypoglycemia, and contrast-enhanced abdominal computed tomography revealed a pancreatic tumor. We diagnosed her with insulinoma and initiated diazoxide treatment to prevent hypoglycemia. After 13 days of treatment, she experienced nasal bleeding, and her platelet count decreased from 186,000 /µL to 28,000 /µL. The thrombocytopenia was ameliorated five days after diazoxide was discontinued. Although diazoxide has hyperglycemic effects associated with decreased insulin secretion, diazoxide-induced thrombocytopenia is rare. A complete blood count should be obtained periodically in patients receiving treatment with diazoxide.
