Rapid Onset of Glycogen Storage Hepatomegaly in a Type-2 Diabetic Patient after a Massive Dose of Long-acting Insulin and Large Doses of Glucose
スポンサーリンク
概要
- 論文の詳細を見る
We present a case of rapid onset of glycogen storage hepatomegaly, caused by a massive dose of long-acting insulin and large doses of glucose, in a type-2 diabetic patient. A 41-year-old man was admitted to our hospital because of hypoglycemia and unconsciousness following subcutaneous administration of 180 units of insulin glargine in a suicide attempt. Despite continuous hypercaloric infusion with additional intravenous glucose injections, hypoglycemia persisted for 36 hours. Although the hepatic function was normal and no hepatomegaly was detected on admission, the liver function tests became abnormal and hepatomegaly was detected on hospitalization day 3. Plain abdominal computed tomography (CT) scanning confirmed liver enlargement, with hepatic CT attenuation markedly elevated at 83.7 HU. Liver biopsy revealed hepatocytic glycogen deposition with edematous degeneration. Based on these findings, the diagnosis was made as rapid onset glycogen storage hepatomegaly caused by administration of a massive dose of long-acting insulin and supplementation with large doses of glucose. With improved glycemic control, the liver function improved, the CT findings of hepatomegaly improved, and the hepatic CT attenuation decreased. Repeat liver biopsy also confirmed almost complete disappearance of glycogen deposits. When hepatic dysfunction or hepatomegaly is detected during treatment with insulin, the possibility of hepatic glycogen deposition should be considered. CT scanning and liver biopsy were useful in diagnosing this case.
- 社団法人 日本内科学会の論文
著者
-
Yoshiji Hitoshi
Third Department Of Internal Medicine Nara Medical University
-
KURIYAMA SHIGEKI
Third Department of Internal Medicine, Kagawa University School of Medicine
-
TSUJIMOTO Tatsuhiro
Third Department of Internal Medicine, Nara Medical University
-
Kuriyama Shigeki
Third Department Of Internal Medicine Kagawa Medical University
-
Okamoto Shingo
Third Department Of Internal Medicine Nara Medical University
-
Uemura Masahito
Third Department Of Internal Medicine Nara Medical University
-
Fukui Hiroshi
Third Department Of Internal Medicine Nara Medical University
-
Matsumura Yoshinobu
Department Of Biotechnology Faculty Of Engineering And High Technology Research Center Kansai Univer
-
Nishiofuku Mariko
Third Department of Internal Medicine, Nara Medical University
-
Takano Masato
Third Department of Internal Medicine, Nara Medical University
関連論文
- ENDOSCOPIC TRANSPAPILLARY CATHETERIZATION INTO THE GALLBLADDER FOR DLAGNOSIS OF GALLBLADDER CARCINOMA
- Estimation of the stent placement above the intact sphincter of Oddi against malignant bile duct obstruction
- Concomitant colitis associated with primary sclerosing cholangitis
- Abnormal bile flow in patients with achalasia
- Assessing the efficacy of famotidine and rebamipide in the treatment of gastric mucosal lesions in patients receiving long-term NSAID therapy (FORCE-famotidine or rebamipide in comparison by endoscopy)
- A case of early gastric malignanat lymphoma diagnosed and completely resected by strip biopsy
- Selective aldosterone blocker, eplerenone, attenuates hepatocellular carcinoma growth and angiogenesis in mice
- Branched-chain amino acids suppress insulin-resistance-based hepatocarcinogenesis in obese diabetic rats
- The role of radixin in altered localization of canalicular conjugate export pump Mrp2 in cholestatic rat liver
- Up-to-date information on gastric mucosal lesions from long-term NSAID therapy in orthopedic outpatients : a study using logistic regression analysis
- Angiotensin-II and vascular endothelial growth factor interaction plays an important role in rat liver fibrosis development
- A potent angiogenic factor, vascular endothelial growth factor, improves the survival of the on-going acute hepatic failure in rats
- Combined effect of an ACE inhibitor, perindopril, and interferon on liver fibrosis markers in patients with chronic hepatitis C
- Intrahepatic Cholangiocarcinoma Associated with Central Calcification and Arterio-portal Shunt
- Onset of Ischemic Colitis Following Use of Electrical Muscle Stimulation (EMS) Exercise Equipment
- Angiotensin-II induces the tissue inhibitor of metalloproteinases-1 through the protein kinase-C signaling pathway in rat liver fibrosis development
- Ultrasonographic findings of amebic colitis
- Stage I mantle-cell lymphoma that was difficult to differentiate from abdominal tuberculous lymphadenitis and metastatic pancreatic cancer
- EXACERBATION OF LIVER FIBROSIS IN TIMP-1 TRANSGENIC MICE
- Interferon treatment of chronic hepatitis C in patients with hemophilia or von Willebrand's disease in Japan
- Nicotine Suppresses Tunicamycin-Induced, But Not Thapsigargin-Induced, Expression of GRP78 during ER Stress-Mediated Apoptosis in PC12 Cells
- A Simplified General Method for Determination of Recombinant Retrovirus Titers
- Effects of "body compression" on parameters related to ascites formation : therapeutic trial in cirrhotic patients
- PE-099 Acute Myocardial Infarction as a Systemically Prothrombotic Condition Evidenced by Increased Ratio of von Willebrand Factor to ADAMTS13(Acute coronary syndrome, basic/clinical-5, The 71st Annual Scientific Meeting of the Japanese Circulation Societ
- Autoreactive helper T cells specific for cytokeratin 19 in patients with autoimmune hepatitis
- Surgical Removal of a Live Worm by Stereotactic Targeting in Cerebral Sparganosis : Case Report
- Pivotal role of ADAMTS13 function in liver diseases
- Aberrant cytokeratin expression and high susceptibility to apoptosis in autoimmune hepatitis
- Isolation and Characterization of Novel Bisphenol : A-Degrading Bacteria from Soils
- Adenocarcinoma arising from aberrant pancreas in the stomach
- Cronkhite-Canada syndrome with colon cancer, portal thrombosis, high titer of antinuclear antibodies, and membranous glomerulonephritis
- Clinical features of liver disturbance in rheumatoid diseases : clinicopathological study with special reference to the cause of liver disturbance
- Microscopic polyangiitis complicated with massive intestinal bleeding
- CASE OF HEMORRHAGE FROM A DUODENAL DIVERTICULUM TREATED SUCCESSFULLY BY ENDOSCOPIC INJECTIONS OF EPINEPHRINE
- Hepatic adenomas treated with percutaneous ethanol injection in a patient with glycogen storage disease type Ia
- Cysteinyl leukotrienes in the bile of patients with obstructive jaundice
- Analysis of the KAL 1 Gene in 19 Japanese Patients with Kallmann Syndrome
- A Novel Mutation of the KAL1 Gene in Kallmann Syndrome
- Radical Esophagogastrectomy for Unshuntable Extrahepatic Portal Hypertension with Bleeding Varices: Report of a Case
- Disappearance of serum HCV-RNA after short-term prednisolone therapy in a patient with chronic hepatitis C associated with autoimmune hepatitis-like serological manifestations
- Mediastinal Pancreatic Pseudocyst Caused by Obstruction of the Pancreatic Duct Was Eliminated by Bromhexine Hydrochloride
- Attenuation of insulin-resistance-based hepatocarcinogenesis and angiogenesis by combined treatment with branched-chain amino acids and angiotensin-converting enzyme inhibitor in obese diabetic rats
- Glycyrrhizin Inhibits TNF-Induced, but Not Fas-Mediated, Apoptosis in the Human Hepatoblastoma Line HepG2
- Fulminant hepatic failure caused by malignant melanoma of unknown primary origin
- Acute hepatic failure due to hepatosplenic B-cell non-Hodgkin's lymphoma in a patient infected with hepatitis C virus
- Drug-induced liver injury in Japan : An analysis of 1676 cases between 1997 and 2006
- Measurement of Left Portal Vein Blood-Flow Velocity by Doppler Sonography in a Patient with Acute Fatty Liver of Pregnancy
- Risk factors for the development of gastric mucosal lesions in rheumatoid arthritis patients receiving long-term nonsteroidal anti-inflammatory drug therapy and the efficacy of famotidine obtained from the FORCE study
- Bacterial cytosine deaminase suicide gene transduction renders hepatocellular carcinoma sensitive to the prodrug 5-fluorocytosine
- Glucocorticoid Therapy Ameliorated Hypoglycemia in Insulin-like Growth Factor-II-producing Solitary Fibrous Tumor
- Hydroxyapatite ceramics as a carrier of gene-transduced bone marrow cells
- Metal-Mediated Control of the Activity of Bacillus subtilis Superoxide Dismutase
- PSEUDOMEMBRANOUS COLITIS COMPLICATING ULCERATIVE COLITIS
- Increased Heat Resistance of Bacillus subtills Spores in Oil
- Use of a Tumbling-Defective Mutant of Escherichia coli for Evaluation of Pollutant Toxicity by Computer-Assisted Image Analysis of Bacterial Motion
- Anti-fibrotic therapy : Are matrix metalloproteinases friends or foes?
- Properties of Bacterial Corrosion of Stainless Steel and Its Inhibition by Protamine Coating
- Killing of Bacillus subtilis by Cell Suicide through Autolysis Induction
- Isolatino and Characterization of Oxygen Sensitive Mutants of Escherichia coli
- Heat-Induced Aggregation and Interaction with Membranes of Cytoplasmic Proteins and the Suppressive Effect of Heat Shock Proteins in Escherichia coli Cells
- Rapid Detection of Spontaneous Bacterial Peritonitis by Granulocyte Elastase Latex Immunoassay and Reagent Strip
- Resistance to Cationic Surfactants and Some Other Agents of Escherichia coli Recombinants with an Abundant Number of Genes Encoding Drug Efflux Pump
- ANTIMICROBIAL ACTIVITY OF PERACETIC ACID PREPARATION IN THE PRESENCE OF VARIOUS COMPOUNDS
- Hydatid Cysts in the Liver
- Rapid Onset of Glycogen Storage Hepatomegaly in a Type-2 Diabetic Patient after a Massive Dose of Long-acting Insulin and Large Doses of Glucose
- ADAMTS13 activity may predict the cumulative survival of patients with liver cirrhosis in comparison with the Child-Turcotte-Pugh score and the Model for End-Stage Liver Disease score