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Accession number;01A1010594
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| Title;A Case of Diabetic Hyperglycemic Hyperosmolar Nonketotic Coma Associated with Transient Nephrogenic Diabetes Insipidus. |
| Author;
KOSUGI E
(Saiseikai Kanagasaken Hospital)
ISHIMORI H
(Saiseikai Kanagasaken Hospital)
NAKANISHI K
(Saiseikai Kanagasaken Hospital)
HIGA M
(Saiseikai Kanagasaken Hospital)
YAMAMURO W
(Saiseikai Kanagasaken Hospital)
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Journal Title;Journal of the Medical Society of Toho University
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Journal Code:G0654A
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ISSN:0040-8670
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VOL.48;NO.4/5;PAGE.365-370(2001)
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| Figure&Table&Reference;FIG.4, TBL.1, REF.7 |
| Pub. Country;Japan |
| Language;English |
| Abstract;A 63-year-old man who had undergone gastro-pancreatectomy for a perforated gastric ulcer one year before admission was brought to the emergency room because of loss of consciousness. The patient had no family history of diabetes mellitus or diabetes insipidus. He was admitted to the intensive care unit with a diagnosis of diabetic hyperglycemic hyperosmolar nonketotic coma (HHNC). Treatment with 0.9% saline (0.45% saline after six hours) and regular insulin was commenced. Twenty-four hours after admission, the plasma glucose, sodium, and serum creatinine levels were normal, and his urine volume increased with plasma hyperosmolarity and lower urine osmolarity. Brain MRI, water deprivation and vasopressin tolerance tests showed that the patient was suffering from nephrogenic diabetes insipidus (DI). Eight days after admission, urine volume had fallen to 2.0 liters and no longer increased. The combination of diabetes mellitus and nephrogenic DI is very rare, though these diseases share common symptoms. To our knowledge, this is a rare reported case of HHNC associated with transient nephrogenic DI, which may have been caused by functional abnormality of microtubules induced by prominent hyperglycemic polyuria. (author abst.) |
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