神经性厌食症患者低血糖昏迷复发。

Recurrence of Hypoglycemic Coma in a Patient with Anorexia Nervosa.

机构信息

Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.

Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.

出版信息

Acta Med Okayama. 2021;75(5):631-636. doi: 10.18926/AMO/62776.

DOI:10.18926/AMO/62776

PMID:34703046

Abstract

Anorexia nervosa (AN) is occasionally complicated with hypoglycemic coma, which may cause sudden death by unknown mechanisms. We present the case of a 36-year-old woman with recurrent comas and a nineteen-year history of AN. She was found in a coma with remarkable hypoglycemia (28 mg/dL). Her BMI was 11.1 kg/m2. Endocrine workup revealed extremely low serum levels of glucagon, IGF-I and insulin. Asymptomatic hypoglycemia occurred with liver injury in the refeeding process. An aberrant glucose metabolism due to liver damage might have been involved in her susceptibility to hypoglycemia. This case suggests a possible mechanism of hypoglycemic coma in AN.

摘要

神经性厌食症（AN）偶尔会并发低血糖性昏迷，其可能通过未知机制导致猝死。我们报告了一例 36 岁女性患者，反复发作昏迷，病史长达 19 年，患有 AN。患者被发现处于昏迷状态，伴有明显低血糖（28mg/dL），BMI 为 11.1kg/m2。内分泌检查显示，血清胰高血糖素、IGF-I 和胰岛素水平极低。在重新喂养过程中，患者出现无症状性低血糖和肝损伤。由于肝损伤导致的葡萄糖代谢异常可能使患者容易发生低血糖。本病例提示了 AN 患者发生低血糖性昏迷的可能机制。