Difficult-to-diagnose diabetes in a patient treated with cyclophosphamide – the contradictory roles of immunosuppressant agents: a case report
| Autor: | Claudia Ramírez-Rentería, Aldo Ferreira-Hermosillo, Manuel García-Sáenz, Daniel Uribe-Cortés |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Adult medicine.medical_specialty Diabetic ketoacidosis Cyclophosphamide medicine.medical_treatment lcsh:Medicine 030209 endocrinology & metabolism Case Report Type 2 diabetes 03 medical and health sciences 0302 clinical medicine Internal medicine Diabetes mellitus medicine Humans Risk factor Family history business.industry Insulin lcsh:R General Medicine medicine.disease Discontinuation Lupus erythematosus systemic 030104 developmental biology Diabetes Mellitus Type 2 Hyperglycemia Female business Immunosuppressive Agents medicine.drug |
| Zdroj: | Journal of Medical Case Reports, Vol 12, Iss 1, Pp 1-4 (2018) Journal of Medical Case Reports |
| ISSN: | 1752-1947 |
| DOI: | 10.1186/s13256-018-1925-3 |
| Popis: | Background Cyclophosphamide may induce autoimmune diabetes through a decrease in suppressor T cells and increase of proinflammatory T helper type 1 response in animal models. In humans, this association is not as clear due to the presence of other risk factors for hyperglycemia, but it could be a precipitant for acute complications. Case presentation A 31-year-old Mestizo-Mexican woman with a history of systemic lupus erythematosus presented with severe diabetic ketoacidosis, shortly after initiating a multi-drug immunosuppressive therapy. She did not meet the diagnostic criteria for type 1 or type 2 diabetes and had no family history of hyperglycemic states. She persisted with hyperglycemia and high insulin requirements until the discontinuation of cyclophosphamide. After this episode, she recovered her endogenous insulin production and the antidiabetic agents were successfully withdrawn. After 1 year of follow up she is still normoglycemic. Conclusion Cyclophosphamide may be an additional risk factor for acute hyperglycemic crisis. Glucose monitoring could be recommended during and after this treatment. |
| Databáze: | OpenAIRE |
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