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- Ohara Nobumasa
- Department of Endocrinology and Metabolism, Nagaoka Red Cross Hospital
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- Kaneko Masanori
- Department of Endocrinology and Metabolism, Nagaoka Red Cross Hospital
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- Kuwano Hirohiko
- Department of Cardiovascular Medicine, Nagaoka Red Cross Hospital
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- Ebe Katsuya
- Department of Cardiovascular Medicine, Nagaoka Red Cross Hospital
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- Fujita Toshio
- Department of Cardiovascular Medicine, Nagaoka Red Cross Hospital
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- Nagai Tsuneo
- Department of Cardiovascular Medicine, Nagaoka Red Cross Hospital
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- Furukawa Tatsuo
- Department of Hematology, Nagaoka Red Cross Hospital
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- Aizawa Yoshifusa
- Department of Research and Development, Tachikawa Medical Center
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- Kamoi Kyuzi
- Department of Center of Diabetes, Endocrinology and Metabolism, Joetsu General Hospital
書誌事項
- タイトル別名
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- A Case Report and Literature Review
この論文をさがす
抄録
A 35-year-old Japanese woman was admitted with coma following flu-like symptoms. She was diagnosed with diabetic ketoacidosis and fulminant type 1 diabetes (FT1D) and received intravenous infusion of insulin and saline. The next day, the ketoacidosis disappeared, and she recovered consciousness. However, extensive ST-segment elevations in the electrocardiogram appeared with a positive troponin test, and the patient developed pulmonary edema on day 3. An echocardiogram showed globally reduced wall motion of the left ventricle and mild pericardial effusion. Despite medical therapy with intravenous furosemide, carperitide, and catecholamines, her cardiac function deteriorated rapidly, with the left ventricular ejection fraction decreasing to 26% within 7 hours, and progressed to cardiogenic shock that afternoon. The patient received mechanical circulatory support for 4 days with intra-aortic balloon pumping and percutaneous cardiopulmonary support, and recovered fully from circulatory failure. A paired serum antibody test showed a significantly elevated titer against parainfluenza-3 virus, indicating a diagnosis of fulminant viral myocarditis. She was discharged on multiple daily insulin injection therapy, and her subsequent clinical course has been uneventful. In summary, we present a case of concurrent FT1D and fulminant viral myocarditis. Parainfluenza-3 viral infection was confirmed serologically and was considered to be a cause of both the FT1D and fulminant myocarditis.
収録刊行物
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- International Heart Journal
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International Heart Journal 56 (2), 239-244, 2015
一般社団法人 インターナショナル・ハート・ジャーナル刊行会