RESUMEN
OBJECTIVE: Canagliflozin is a sodium-glucose co-transporter 2 (SGLT-2) inhibitor, one of a class of novel antiglycemic agents that are gaining in popularity in the treatment of diabetes. METHODS: We describe a case in which a patient experienced difficult-to-treat metabolic ketoacidosis in the setting of canagliflozin use. RESULTS: A 52-year-old man with type 2 diabetes mellitus developed profound ketoacidosis without overt hyperglycemia while taking canagliflozin. Despite initiation of an insulin infusion, the metabolic acidosis persisted for 3 days. CONCLUSION: Treatment with canagliflozin was associated with development of euglycemic ketoacidosis.
Asunto(s)
Canagliflozina/efectos adversos , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hipoglucemiantes/efectos adversos , Cetosis/inducido químicamente , Cetosis/terapia , Glucemia/análisis , Humanos , Masculino , Persona de Mediana EdadAsunto(s)
Acromegalia/etiología , Adenoma/metabolismo , Hormona de Crecimiento Humana/metabolismo , Síndromes Paraneoplásicos Endocrinos/diagnóstico , Neoplasias Hipofisarias/metabolismo , Acromegalia/diagnóstico , Adenoma/diagnóstico , Adenoma/terapia , Terapia Combinada , Diagnóstico Diferencial , Femenino , Dedos , Hormona de Crecimiento Humana/sangre , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Síndromes Paraneoplásicos Endocrinos/sangre , Síndromes Paraneoplásicos Endocrinos/terapia , Neoplasias Hipofisarias/diagnóstico , Neoplasias Hipofisarias/terapia , Seno EsfenoidalRESUMEN
We present two patients in whom marked changes in dual-energy X-ray absorptiometry (DXA)-measured bone mineral density were found to be the result of prior administration of technetium-99m methylene diphosphonate (MDP) for bone scanning. In patient 1, an artifactual 50% decrease in lumbar spine and 19% decrease in left total hip bone density over a 14-mo period was the result of technetium-99m injection 3 h before the second bone density measurement. In patient 2, a dramatic increase in bone density at 6 mo was the result of artifactual reduction in bone density on the baseline study as a result of technetium-99m injection 2 h earlier. Clinicians and technologists should be aware that technetium-99m used for bone scanning could cause artifactual reduction in DXA-measured bone mineral density.
