一例2型糖尿病合并肺癌患者在使用免疫检查点抑制剂后出现优生糖尿病酮症,并伴有肾上腺功能不全。

IF 0.9 Q4 ENDOCRINOLOGY & METABOLISM Case Reports in Endocrinology Pub Date : 2024-02-20 eCollection Date: 2024-01-01 DOI:10.1155/2024/9982174
Saeko Shibasaki, Chisei Noda, Akihisa Imagawa, Sadaki Sakane
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引用次数: 0

摘要

一名 74 岁的 2 型糖尿病患者接受了基础胰岛素、胰岛素促泌剂和钠葡萄糖转运体 2 (SGLT2) 抑制剂治疗。在接受肺癌免疫检查点抑制剂治疗后,他出现了意识障碍,尿酮体(3+)。停止所有降糖治疗后,他的血糖仍保持在 121 毫克/分升。他被诊断为优生糖尿病酮症。内分泌负荷试验显示,孤立的促肾上腺皮质激素(ACTH)缺乏是一种与免疫相关的不良反应。有研究认为,优生糖尿病酮症是由胰岛素和胰岛素促泌剂的自我悬浮、肾上腺功能不全、SGLT2 抑制剂和碳水化合物摄入不足诱发的。
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A Case of Type 2 Diabetes Mellitus with Lung Cancer Suffered from Euglycemic Diabetic Ketosis Accompanied by Adrenal Insufficiency after Immune Checkpoint Inhibitors.

A 74-year-old patient with type 2 diabetes mellitus received basal-bolus insulin, insulin secretagogues, and sodium glucose transporter 2 (SGLT2) inhibitors. After immune checkpoint inhibitor treatment for lung cancer, he suffered from depressed consciousness with a urinary ketone body (3+). When all hypoglycemic treatments were discontinued, his serum blood glucose remained at 121 mg/dL. He was diagnosed with euglycemic diabetic ketosis. Endocrine loading tests revealed isolated adrenocorticotropic hormone (ACTH) deficiency as an immune-related adverse event. It was suggested that euglycemic diabetic ketosis was induced by the self-suspension of insulin and insulin secretagogues, adrenal insufficiency, SGLT2 inhibitors, and carbohydrate intake shortage.

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来源期刊
Case Reports in Endocrinology
Case Reports in Endocrinology ENDOCRINOLOGY & METABOLISM-
CiteScore
2.10
自引率
0.00%
发文量
45
审稿时长
13 weeks
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