The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Case of Recurrent Spontaneous Hypoglycemia in a 73-year-old Woman with Congestive Heart Failure

심부전 환자에서 발생한 반복적인 자발성 저혈당과 의식저하 1예

  • Kim, Kyehwan (Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Kim, Wan Chul (Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Lee, Eun-Ju (Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Koh, Jin-Sin (Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Park, Jeong Rang (Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Hahm, Jong Ryeal (Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Hwang, Jin-Yong (Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine)
  • 김계환 (경상대학교 의학전문대학원 경상대학교병원 내과) ;
  • 김완철 (경상대학교 의학전문대학원 경상대학교병원 내과) ;
  • 이은주 (경상대학교 의학전문대학원 경상대학교병원 내과) ;
  • 고진신 (경상대학교 의학전문대학원 경상대학교병원 내과) ;
  • 박정랑 (경상대학교 의학전문대학원 경상대학교병원 내과) ;
  • 함종렬 (경상대학교 의학전문대학원 경상대학교병원 내과) ;
  • 황진용 (경상대학교 의학전문대학원 경상대학교병원 내과)
  • Received : 2013.07.07
  • Accepted : 2013.09.09
  • Published : 2014.08.01
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Abstract

Hypoglycemia in adults without diabetes can be caused by drugs, critical illness, hormone deficiency, and hyperinsulinism. Spontaneous hypoglycemia in congestive heart failure has been reported rarely in adults. We report a case of spontaneous hypoglycemia in congestive heart failure in a 73-year-old woman with mitral stenosis and atrial fibrillation who had been receiving treatment for 6 years. She had two episodes of low serum glucose with unconsciousness, but there was no evidence of diabetes. Heart failure with concomitant hepatic dysfunction was presumed to have caused the hypoglycemia. She underwent mitral valve replacement after being diagnosed with severe mitral stenosis. There was no episode of hypoglycemia during follow-up.

저자들은 반복적인 저혈당에 의한 의식저하를 주소로 내원한 심부전 환자로 수술적 치료 이후 1년간 저혈당 및 심부전 악화 없이 외래 경과관찰 중인 환자 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Williams AF. Hypoglycaemia of the newborn: a review. Bull World Health Organ 1997;75:261-290.
  2. Hedayati HA, Beheshti M. Profound spontaneous hypoglycaemia in congestive heart failure. Curr Med Res Opin 1977;4:501-504. https://doi.org/10.1185/03007997709109340
  3. Khoury H, Daugherty T, Ehsanipoor K. Spontaneous hypoglycemia associated with congestive heart failure attributable to hyperinsulinism. Endocr Pract 1998;4:94-95. https://doi.org/10.4158/EP.4.2.94
  4. Mellinkoff SM, Tumulty PA. Hepatic hypoglycemia; its occurrence in congestive heart failure. N Engl J Med 1952;247:745-750. https://doi.org/10.1056/NEJM195211132472001
  5. Benzing G 3rd, Schubert W, Sug G, Kaplan S. Simultaneous hypoglycemia and acute congestive heart failure. Circulation 1969;40:209-216. https://doi.org/10.1161/01.CIR.40.2.209
  6. Ng CL. Hypoglycaemia in nondiabetic patients-an evidence. Aust Fam Physician 2010;39:399-404.
  7. Ukena C, Dobre D, Mahfoud F, et al. Hypo- and hyperglycemia predict outcome in patients with left ventricular dysfunction after acute myocardial infarction: data from EPHESUS. J Card Fail 2012;18:439-445. https://doi.org/10.1016/j.cardfail.2012.03.002
  8. Desouza CV, Bolli GB, Fonseca V. Hypoglycemia, diabetes, and cardiovascular events. Diabetes Care 2010;33:1389-1394. https://doi.org/10.2337/dc09-2082
  9. Bolli G, De Feo P, Perriello G, et al. Role of hepatic autoregulation in defense against hypoglycemia in humans. J Clin Invest 1985;75:1623-1631. https://doi.org/10.1172/JCI111869
  10. Issa VS, Amaral AF, Cruz FD, et al. Beta-blocker therapy and mortality of patients with Chagas cardiomyopathy: a subanalysis of the REMADHE prospective trial. Circ Heart Fail 2010;3:82-88. https://doi.org/10.1161/CIRCHEARTFAILURE.109.882035

Cited by

  1. Cardiac Arrest in Conjunction with Hypoglycemia in a Non-Diabetic Patient with Cerebral Infarction vol.11, pp.2, 2018, https://doi.org/10.18700/jnc.180063