Kubota S, Yamada Y, Wakasugi H, Kou T, Matsumoto J, Irie K
Department of Internal Medicine, National Kyushu Cancer Center, Fukuoka.
Fukuoka Igaku Zasshi. 1996 Oct;87(10):226-8.
This paper presents a 59-year-old man who was admitted to our hospital because of abdominal pains in 1973. He had pancreatic calcification and showed high levels of serum amylase, Ca, and PTH. He was diagnosed as primary hyperparathyroidism with chronic pancreatitis. After excision of an ectopic parathyroid adenoma, serum Ca levels were decreased and normalized by dihydrotachysterol p.o. At the same time his symptoms disappeared. The exocrine and endocrine pancreatic functions, however, decreased gradually. Diabetes mellitus appeared in 1975 and he required insulin injection since 1983. In spite of the treatment, his diabetic control was poor. Seventeen years later in 1992, he showed hypertension and edema (nephrotic syndrome). Because of renal failure, he underwent hemodialysis and passed away due to myocardial infarction in 1993. Autopsy findings showed existence of diabetic nephropathy as the cause of renal failure. Clinical course of this patient suggests that severe complications occur even in pancreatic diabetes and that we have to control diabetes strictly in pancreatic diabetes as well as in primary diabetes.
本文介绍了一位59岁男性，他于1973年因腹痛入院。他有胰腺钙化，血清淀粉酶、钙和甲状旁腺激素水平升高。他被诊断为原发性甲状旁腺功能亢进合并慢性胰腺炎。切除异位甲状旁腺腺瘤后，血清钙水平下降，并通过口服双氢速甾醇恢复正常。同时他的症状消失。然而，胰腺的外分泌和内分泌功能逐渐下降。1975年出现糖尿病，自1983年起他需要注射胰岛素。尽管进行了治疗，他的糖尿病控制仍很差。17年后的1992年，他出现高血压和水肿（肾病综合征）。由于肾衰竭，他接受了血液透析，并于1993年因心肌梗死去世。尸检结果显示存在糖尿病肾病，这是肾衰竭的原因。该患者的临床病程表明，即使在胰腺性糖尿病中也会出现严重并发症，而且我们必须像在原发性糖尿病中一样严格控制胰腺性糖尿病。
