フェンホルミンによる乳酸アシドーシスの1例

書誌事項

タイトル別名
  • A Case of Lactic Acidosis Associated with Phenformin Administration
  • フェンホルミン ニヨル ニュウサン アシドーシス ノ 1レイ

この論文をさがす

抄録

A 49-yr-old housewife was admitted to hospital due to loss of consciousness. Since 1962 (50 yr of age) she had complained of increased appetite, thirst and loss of body weight. In 1963 she was diagnosed as a diabetic. At first, diet therapy was initiated but later glibenclamide (5-10 mg, daily) and phenformin (100 mg, daily) were administered. No liver damage orrenal damage was observed. The degree of diabetic retinopathy was Scott I. At the end of July 1976, diarrhea appeared. The patient complained of miction pain on August 7 and was administered antibiotics due to urocystitis. Next afternoon, abdominal pain and nausea appeared. She stopped taking the antibiotics, but still continued to have hypoglycemic agents of the same dose irrespective of any nausea and vomitting. On August 10 she was unable to have meal. In the afternoon, impairment of consciousness appeared and she fell into a coma. On admission, the patient was in a state of shock. Her body temperature was 35.7°C and her pulse weak. Her systolic blood pressure was 56 mmHg. Respiration rate was 30/min. All the deep tendon reflexes were absent. The chief laboratory findings were as follows. Blood sugar was 200μg/dl without ketonuria, the arterial pH was 6. 95, and the base excess was-31 mEq/L. The blood level of lactic acid was 27.8 mM and the anion gap was 41 mEq/L. Plasma amino acid analysis revealed hyperalaninemia and the plasma glucagon immunoreactivity was 1, 021 pg/ml. Infusion of sodium bicarbonate, glucose and a small dose insulin was begun and 4 mg prednisolone was injected intravenoushy. Next morning the blood pressure had returned to a normal level. After if: months, the patient left the hospital with impaired intelligence.

収録刊行物

  • 糖尿病

    糖尿病 21 (9), 865-871, 1978

    一般社団法人 日本糖尿病学会

被引用文献 (1)*注記

もっと見る

詳細情報

問題の指摘

ページトップへ