Isotani H, Fujimura Y, Furukawa K, Morita K
Department of Internal Medicine, Hirakata City Hospital, Osaka, Japan.
Diabetes Res Clin Pract. 1996 Sep;34(1):57-60. doi: 10.1016/s0168-8227(96)01330-7.
We report a case of diabetic ketoacidosis (DKA) associated with pheochromocytoma in a college student of 22 years of age who was admitted to hospital because of hyperglycemia and hypertension with palpitations and subsequently was found to have an adrenalin and noradrenalin secreting pheochromocytoma. A diagnosis was made and the patient's impaired glucose tolerance and hypertension improved by tumor excision. This is the first reported case of a noradrenalin-predominant pheochromocytoma with associated DKA. Although DKA has been thought not to occur with pheochromocytoma, the possible cause of DKA associated with pheochromocytoma is now described. It is important to point out, as a clinical manager, that severe hypertension is a very unusual concomitant of DKA in young people and is the main indication for further examination.
我们报告一例22岁大学生糖尿病酮症酸中毒(DKA)合并嗜铬细胞瘤的病例。该患者因高血糖、高血压伴心悸入院,随后被发现患有分泌肾上腺素和去甲肾上腺素的嗜铬细胞瘤。确诊后,通过肿瘤切除,患者受损的糖耐量和高血压得到改善。这是首例报道的以去甲肾上腺素为主的嗜铬细胞瘤合并DKA的病例。尽管过去认为DKA不会与嗜铬细胞瘤同时发生,但现在描述了与嗜铬细胞瘤相关的DKA的可能病因。作为临床管理人员需要指出的是,严重高血压在年轻人DKA中是非常罕见的伴随症状,是进一步检查的主要指征。