Öz
Akromegalide glukoz metabolizması anormallikleri sık görüldüğü halde,
diyabetik ketoasidoz nadir bir komplikasyon olarak tanımlanmıştır. Bu makalede
42 yaşında diyabetik ketoasidozlu bir olgu sunulmaktadır. Metabolik bozukluk
için bir sebep bulunamayan, insülin ihtiyacı çok yüksek olan olguda laboratuvar
çalışmaları ile akromegali saptandı. Hipofiz adenomuna yönelik cerrahi sonrası
insülin ihtiyacı belirgin olarak azaldı. Olgumuz nadir bir durum olan diyabetik
ketoasidoz ile akromegali birlikteliğini göstermektedir. Akromegali yüksek doz
insülin ihtiyacının ayırıcı tanısında göz önünde bulundurulmalıdır.
Anahtar Kelimeler
Kaynakça
- Chanson P, Salenave S, Kamenicky P, Cazabat L, Young J. Pituitary tumours: acromegaly. Best Pract Res Clin Endocrinol Metab 2009; 23: 555-74.
- Yoshida N, Goto H, Suzuki H, et al. Ketoacidosis as the initial clinical condition in nine patients with acromegaly: a review of 860 cases at a single institute. Eur J Endocrinol 2013; 169: 127-32.
- Colao A, Ferone D, Marzullo P, Lombardi G. Systemic complications of acromegaly: epidemiology, pathogenesis, and management. Endocr Rev 2004; 25: 102-52.
- Chen YL, Wei CP, Lee CC, Chang TC. Diabetic ketoacidosis in a patient with acromegaly. J Formos Med Assoc 2007; 106: 788-91.
- Dosi RV, Patell RD, Shah PJ, Joshi HK. Diabetic ketoacidosis: an unusual presentation of acromegaly. BMJ Case Rep 2013; doi:10.1136/bcr-2013-010198.
- Jiang HJ, Hung WW, Hsiao PJ. A case of acromegaly complicated with diabetic ketoacidosis, pituitary apoplexy, and lymphoma. Kaohsiung J Med Sci 2013; 29: 687-90.
- Vijayakumar A, Novosyadlyy R, Wu Y, Yakar S, LeRoith D. Biological effects of growth hormone on carbohydrate and lipid metabolism. Growth Horm IGF Res 2010; 20: 1-7.
- Palakawong P, Arakaki R. Diabetic Ketoacidosis in Acromegaly: A Case Report. Endocr Pract 2012: 1-15.
- Kinoshita Y, Fujii H, Takeshita A, et al. Impaired glucose metabolism in Japanese patients with acromegaly is restored after successful pituitary surgery if pancreatic {beta}-cell function is preserved. Eur J Endocrinol 2011; 164: 467-73.
Öz
Although the abnormalities of glucose metabolism were common in
acromegaly, diabetic ketoacidosis was described as a rare complication. A case
of 42-year-old woman who had diabetic ketoacidosis in this case report.
Laboratory studies were confirmed the diagnosis of acromegaly in patient which
had no specific cause for metabolic derangement and insulin need was very high.
After the pituitary adenoma removed surgically, insulin need was markedly
reduced. This case shows the rare association between diabetic ketoacidosis and
acromegaly. Acromegaly should be considered in the differential diagnosis of
high dose insulin needed.
Anahtar Kelimeler
Kaynakça
- Chanson P, Salenave S, Kamenicky P, Cazabat L, Young J. Pituitary tumours: acromegaly. Best Pract Res Clin Endocrinol Metab 2009; 23: 555-74.
- Yoshida N, Goto H, Suzuki H, et al. Ketoacidosis as the initial clinical condition in nine patients with acromegaly: a review of 860 cases at a single institute. Eur J Endocrinol 2013; 169: 127-32.
- Colao A, Ferone D, Marzullo P, Lombardi G. Systemic complications of acromegaly: epidemiology, pathogenesis, and management. Endocr Rev 2004; 25: 102-52.
- Chen YL, Wei CP, Lee CC, Chang TC. Diabetic ketoacidosis in a patient with acromegaly. J Formos Med Assoc 2007; 106: 788-91.
- Dosi RV, Patell RD, Shah PJ, Joshi HK. Diabetic ketoacidosis: an unusual presentation of acromegaly. BMJ Case Rep 2013; doi:10.1136/bcr-2013-010198.
- Jiang HJ, Hung WW, Hsiao PJ. A case of acromegaly complicated with diabetic ketoacidosis, pituitary apoplexy, and lymphoma. Kaohsiung J Med Sci 2013; 29: 687-90.
- Vijayakumar A, Novosyadlyy R, Wu Y, Yakar S, LeRoith D. Biological effects of growth hormone on carbohydrate and lipid metabolism. Growth Horm IGF Res 2010; 20: 1-7.
- Palakawong P, Arakaki R. Diabetic Ketoacidosis in Acromegaly: A Case Report. Endocr Pract 2012: 1-15.
- Kinoshita Y, Fujii H, Takeshita A, et al. Impaired glucose metabolism in Japanese patients with acromegaly is restored after successful pituitary surgery if pancreatic {beta}-cell function is preserved. Eur J Endocrinol 2011; 164: 467-73.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Olgu sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 22 Temmuz 2019 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 3 Sayı: 1 |
