維持透析の経過中に低血糖発作を初発症状として発症した急性壊死性すい炎の１例

DOI

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タイトル別名
  • Acute necrotizing pancreatitis in a hemodialysis patient manifested by severe hypoglycemia. A case report.

抄録

Acute pancreatitis is one of the most serious complications in dialysis patients. We report a hemodialysed patient with acute necrotizing pancreatitis showing hypoglycemia as the initial manifestation. A 65-year-old male on maintenance hemodialysis for 4 years was admitted to our hospital because of unconsciousness. The patient had a history of chronic thyroiditis for 5 years. However, there was no prior history of diabetes mellitus. On admission, his laboratory findings included marked hypoglycemia (13mg/dl), leukocytosis, and high LDH levels with scant abdominal symptoms. His initial serum amylase level was in the normal range (50IU/dl). After intravenous administration of dextrose, the patient regained consciousness immediately. He denied having taken oral hypoglycemic agents, or any other drugs modulating glycemic control. On the 12th hospital day, severe abdominal pain developed. Subsequently, the patient got into shock accompanied by severe hypoglycemia and lactic acidosis. At that time, abdominal CT scan was performed, and the diagnosis of acute pancreatitis was made. Despite the intensive treatments, the patient died from multiple organ dysfunction syndrome. Autopsy revealed widespread necrotizing pancreatitis.<br>Although hypoglycemia is a rare manifestation of acute pancreatitis, this combination has been reported in chronic hemodialysis patients. We conclude that hypoglycemia and lactic acidosis might be one of the clinical clues for diagnosing severe necrotizing pancreatitis in hemodialyzed patients.

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詳細情報 詳細情報について

  • CRID
    1390001204676011776
  • NII論文ID
    130003875008
  • DOI
    10.4009/jsdt.33.1469
  • ISSN
    1883082X
    13403451
  • 本文言語コード
    ja
  • データソース種別
    • JaLC
    • Crossref
    • CiNii Articles
  • 抄録ライセンスフラグ
    使用不可

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