一名患有格雷夫斯病的老年患者出现缓慢进展的胰岛素依赖型糖尿病。

Slowly progressive insulin-dependent diabetes mellitus in an elderly patient with Graves' disease.

作者信息

Saitoh T, Akamine N, Sakai T, Serizawa S, Tohno H, Horie T

机构信息

First Department of Internal Medicine, Nihon University School of Medicine, Tokyo.

出版信息

Intern Med. 2000 Nov;39(11):943-6. doi: 10.2169/internalmedicine.39.943.

DOI:10.2169/internalmedicine.39.943

PMID:11065248

Abstract

We report a case of slowly progressive insulin-dependent diabetes mellitus in an elderly patient with Graves' disease. A 69-year-old man presented with apathetic thyrotoxicosis and weight loss. Laboratory findings indicated insulin-dependent diabetes mellitus (IDDM) with Graves' disease. Human leukocyte antigens DR4 and DR9, which are recognized as markers for IDDM with autoimmune thyroid disease, were detected. The clinical course of the IDDM was compatible with the slowly progressive type. Onset of this disease during old age is rare, and such cases should be analyzed with a thyroid function test because the symptom of thyrotoxicosis may be masked in the elderly.

摘要

我们报告了一例老年格雷夫斯病患者出现缓慢进展的胰岛素依赖型糖尿病的病例。一名69岁男性表现为淡漠型甲状腺毒症和体重减轻。实验室检查结果显示为伴有格雷夫斯病的胰岛素依赖型糖尿病（IDDM）。检测到人类白细胞抗原DR4和DR9，它们被认为是自身免疫性甲状腺疾病伴IDDM的标志物。IDDM的临床病程符合缓慢进展型。这种疾病在老年时发病较为罕见，由于老年患者甲状腺毒症症状可能被掩盖，因此对此类病例应进行甲状腺功能检查。