Cardiovascular Department, Guangzhou University of Chinese Medicine, Guangzhou, China.
The Department of Nephrology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Front Endocrinol (Lausanne). 2022 Aug 3;13:914325. doi: 10.3389/fendo.2022.914325. eCollection 2022.
A 62-year-old man was diagnosed as IgA nephropathy. He had a pancreatic tumor operation 19 years ago and had a normal plasma glucose test every year. One month after the medication of prednisolone acetate was administered his fasting plasma glucose elevated to 7.1mmol/L while he manifested symptoms of thirst, frequent urination, and weight loss. Approximately 3 months after the steroids, he started complaining of numbness, weakness, and muscle cramp in his lower extremities, blood tests showed elevated plasma glucose and electromyography (EMG) revealed impairment of the peripheral nerves in the lower extremity, diabetic peripheral neuropathy was diagnosed. Mecobalamin and Acupuncture were employed and steroids were discontinued, 8 months later he recovered part of his strength and sensation. This case presents a specific adverse drug reaction of corticosteroids that causes diabetes mellitus and subsequently leads to peripheral neuropathy in an acute onset.
一位 62 岁男性,诊断为 IgA 肾病。19 年前因胰腺肿瘤行手术治疗,每年均行血浆葡萄糖检查,结果正常。1 个月前予醋酸泼尼松龙治疗后,出现口干、多饮、消瘦,空腹血糖升高至 7.1mmol/L。停用激素约 3 个月后,诉双下肢麻木、乏力、肌肉痉挛,查血提示血糖升高,肌电图(EMG)示双下肢周围神经损害,诊断为糖尿病周围神经病。予甲钴胺、针灸治疗,停用激素,8 个月后,下肢肌力、感觉部分恢复。本例为糖皮质激素导致糖尿病,继而急性起病发生周围神经病的特殊药物不良反应。