The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

A case of hyperosmolar nonketotic coma associated with androgen deprivation therapy in prostate cancer

전립선암 남성호르몬 박탈 치료 후 발생한 비케톤성 고삼투압성 혼수 1예

  • Hong, Eun-Yeong (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Lee, Seok-Won (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Kang, Jun-Goo (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Kim, Chul-Sik (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Ihm, Sung-Hee (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Yoo, Hyung-Joon (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Lee, Seong-Jin (Department of Internal Medicine, Hallym University College of Medicine)
  • 홍은영 (한림대학교 의과대학 내과학교실) ;
  • 이석원 (한림대학교 의과대학 내과학교실) ;
  • 강준구 (한림대학교 의과대학 내과학교실) ;
  • 김철식 (한림대학교 의과대학 내과학교실) ;
  • 임성희 (한림대학교 의과대학 내과학교실) ;
  • 유형준 (한림대학교 의과대학 내과학교실) ;
  • 이성진 (한림대학교 의과대학 내과학교실)
  • Received : 2009.09.05
  • Accepted : 2009.11.16
  • Published : 2010.11.01
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Abstract

During advanced prostate cancer, androgen deprivation therapy (ADT) using gonadotropin-releasing hormone and antiandrogen is an effective treatment modality. Recently, it has been reported that ADT may result in diabetes mellitus (DM), metabolic syndrome, and cardiovascular disease. Here, we report the first case in the literature of new-onset DM and hyperosmolar nonketotic coma (HNKC) associated with ADT. A 69-year-old man visited our hospital because of altered mentality. The patient had been taking leuprolide and bicalutamide for metastatic prostate cancer for the past 4 months. In laboratory tests, new-onset DM with HNKC was diagnosed. The patient was immediately treated with intravenous hydration and insulin therapy, and recovered without sequela. Because ADT can cause DM, or rarely HNKC, it is necessary to monitor fasting blood glucose and lipid profiles carefully while ADT is performed.

저자들은 골(骨) 전이를 동반한 전립선암으로 남성호르몬 박탈 치료를 받던 중 제2형 당뇨병, 비케톤성 고삼투압성 혼수, 급성 신부전이 발생하여 충분한 수액공급과 인슐린 투여 등의 집중 치료를 시행한 후 호전된 증례를 처음으로 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

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