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一名1型糖尿病控制不佳的患者在感染新冠病毒后出现自主神经功能障碍的病例。

A case of dysautonomia after COVID-19 infection in a patient with poorly controlled type I diabetes.

作者信息

Aitkens Lorry, Downey George

机构信息

Department of Internal Medicine Medical College of Georgia at Augusta University Augusta Georgia USA.

出版信息

Clin Case Rep. 2023 Jan 23;11(1):e6889. doi: 10.1002/ccr3.6889. eCollection 2023 Jan.

Abstract

COVID-19 has been linked to dysautonomia in the current literature, as has uncontrolled diabetes. Here, we present a case report of severe dysautonomia following a COVID-19 infection in a patient with pre-existing poorly controlled type-1 diabetes. This patient exhibited symptoms consistent with both postural orthostatic tachycardia syndrome (POTS), as well as orthostatic hypotension. His symptoms became so severe that he was unable to come to a standing position without experiencing syncope. Extensive workup was completed to identify an alternative cause of his dysautonomia with inconclusive results. Dysautonomia can have devastating consequences in regard to physical, social, and psychological health. Counseling individuals with poorly controlled diabetes about the importance of maintaining tight blood glucose control and avoiding COVID-19 infection should be primary interventions when treating patients with this DM1. Early detection and management of diabetes mellitus, COVID-19, and of possible resultant dysautonomia through medical interventions, as well as lifestyle changes, are extremely important measures to avoid development of dangerous and potentially life-threatening consequences.

摘要

在当前文献中,新型冠状病毒肺炎(COVID-19)已被证明与自主神经功能障碍有关,未得到控制的糖尿病亦是如此。在此,我们报告一例先前1型糖尿病控制不佳的患者在感染COVID-19后出现严重自主神经功能障碍的病例。该患者表现出与体位性直立性心动过速综合征(POTS)以及直立性低血压相一致的症状。其症状变得非常严重,以至于在不发生晕厥的情况下无法站立。为确定其自主神经功能障碍的其他病因进行了全面检查,但结果尚无定论。自主神经功能障碍在身体、社交和心理健康方面可能会产生毁灭性后果。在治疗1型糖尿病患者时,首要干预措施应是向糖尿病控制不佳的患者宣传维持严格血糖控制以及避免感染COVID-19的重要性。通过医学干预以及生活方式改变,早期发现和管理糖尿病、COVID-19以及可能由此导致的自主神经功能障碍,是避免出现危险且可能危及生命后果的极其重要的措施。

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