Department of Paediatrics, University of Auckland, Auckland, New Zealand; Starship Children's Health, Auckland, New Zealand.
Hawkes Bay Hospital, Hastings, New Zealand.
J Cyst Fibros. 2021 Mar;20(2):330-332. doi: 10.1016/j.jcf.2020.08.018. Epub 2020 Sep 11.
Hyperosmolar hyperglycaemic state (HHS) has not previously been reported in cystic fibrosis-related diabetes (CFRD). We report the case of a 15-year old boy with stable CFRD who developed acute HHS after treatment with glucocorticoids and itraconazole for presumed allergic broncho-pulmonary aspergillosis (ABPA). This case highlights the dangerous and preventable combination of high glucose intake, glucocorticoids and itraconazole inhibition of CYP3A4 (with resultant glucocorticoid accumulation) that can result in a state of life- threatening HHS in an adolescent with previously stable CFRD.
高渗性高血糖状态（HHS）以前并未在囊性纤维化相关糖尿病（CFRD）中报告过。我们报告了一例 15 岁男孩的病例，该男孩患有稳定的 CFRD，在因疑似变应性支气管肺曲霉病（ABPA）而接受糖皮质激素和伊曲康唑治疗后，发生了急性 HHS。该病例突出了高血糖摄入、糖皮质激素和伊曲康唑抑制 CYP3A4（导致糖皮质激素蓄积）的危险且可预防的组合，这可能导致以前稳定的 CFRD 的青少年发生危及生命的 HHS 状态。
