Cetoacidosis diabética reversible con metotrexato: Resistencia al tratamiento insulínico. Caso clínico / Diabetic ketoacidosis responsive to methotrexate in a patient with a mixed connective tissue disease
Rev. méd. Chile
; 135(1): 87-91, ene. 2007. tab
Artigo
em Espanhol
| LILACS
| ID: lil-442995
Biblioteca responsável:
BR1.1
ABSTRACT
We report a 42 year-old woman with a hypothyroidism and a mixed connective tissue disease treated with prednisone and methotrexate. The patient had normal blood glucose levels but when the methotrexate dose was tapered, she presented a diabetic ketoacidosis that required up to 520 units of insulin per day. Due to the intensification of the mixed connective tissue disease symptoms, the doses of methotrexate and prednisone were increased again with a simultaneous normalization of serum glucose levels and glucose tolerance. In the following six months, when the dose of methotrexate was tapered again, the hyperglycemia reappeared and was again controlled increasing the dose. Thirty months after the episode of keotacidosis, the patient was with a weekly dose of methotrexate, asymptomatic and with a normal glucose tolerance. Anti insulin antibodies were not detected and anti islet antibodies were indeterminate, due to interference with antinuclear antibodies. It is possible that the episode of ketoacidosis was unveiled by an autoimmune phenomenon.
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Contexto em Saúde:
ODS3 - Saúde e Bem-Estar
Problema de saúde:
Meta 3.5 Prevenção e tratamento do consumo de substâncias psicoativas
Base de dados:
LILACS
Assunto principal:
Resistência à Insulina
/
Metotrexato
/
Cetoacidose Diabética
/
Imunossupressores
/
Doença Mista do Tecido Conjuntivo
Tipo de estudo:
Estudo de etiologia
Limite:
Adulto
/
Feminino
/
Humanos
Idioma:
Espanhol
Revista:
Rev. méd. Chile
Assunto da revista:
Medicina
Ano de publicação:
2007
Tipo de documento:
Artigo
País de afiliação:
Chile
Instituição/País de afiliação:
Servicio de Salud Viña del Mar/CL
/
Universidad de Valparaíso/CL