糖尿病性昏睡と甲状腺クリーゼの合併例

概要

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The simultaneous occurence of thyroid crisis and severe diabetic ketoacidosis is rare. This coexistence of two life-threatening illnesses is most dangerous for the patient. The case reported in this paper is a 41 year old woman with goiter of 4 years duration. In family history, her mother died of diabetes mellstcs. For 2-3 weeks prior to admission the patient was treated with the diagnosis of diabetes mellitus. And one day prior to admission she complained of vomitting, palpitation and dyspnea. On arrival at our hospital, the body temperature was 36.7°C and the blood pressure was 140/80 mmHg. The pulse was 90-100 per minute, but about two hours later it was elevated to 174 per minute. After two days, acetone was detected in urine in spite of treatment for diabetes and hyperthyroidism. Four days later she died of heart failure. In this patient, moist skin, extremely high blood and urinary sugar and no heat intolerance were suspected of diabetic coma, but hypertension, tachycardia, thyromegaly and delirium were suspected of thyroid crisis. Although the specific signs and symptoms of diabetic coma and thyroid crisis were almost present in this case, the typical symptoms of these two diseases were partially absent.
日本内分泌学会の論文