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http://dx.doi.org/10.3904/kjm.2014.86.6.761

Case Report of Everolimus-Associated DKA in a Patient with Metastatic Renal Cell Carcinoma  

Kim, Lee-Kyung (Department of Internal Medicine, Seoul National University College of Medicine)
Ahn, Chang Ho (Department of Internal Medicine, Seoul National University College of Medicine)
Lee, Jie Eun (Department of Internal Medicine, Seoul National University College of Medicine)
Jung, Chan-Hyeon (Department of Internal Medicine, Seoul National University College of Medicine)
Koo, Bo Kyung (Department of Internal Medicine, Seoul National University College of Medicine)
Moon, Min Kyong (Department of Internal Medicine, Seoul National University College of Medicine)
Publication Information
The Korean Journal of Medicine / v.86, no.6, 2014 , pp. 761-765 More about this Journal
Abstract
Everolimus, an inhibitor of the mammalian target of the rapamycin (mTOR) pathway, is widely used as an immunosuppressant for the prevention of organ rejection following transplant and to treat metastatic clear-cell type renal cell carcinoma (RCC), breast cancer, and pancreatic neuroendocrine tumors. Everolimus commonly induces metabolic abnormalities such as hyperglycemia, hypercholesterolemia, and hypertriglyceridemia due to concomitant increases in blood glucose levels via the induction of insulin resistance and a decrease in ${\beta}$ cell function, which both lead to insulin deficiency. Although abnormal blood glucose levels are observed in more than 50% of patients treated with Everolimus, hyperglycemia exceeding 500 mg/dL is not common and there have been no reports of Everolimus-induced acute hyperglycemic crisis conditions. Here, a novel case of Everolimus-associated diabetic ketoacidosis (DKA) in a patient with RCC is reported.
Keywords
Everolimus; DKA; Hyperglycemia; Insulin resistance; Metastatic renal cell carcinoma;
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