아토피성 피부염 환자에서 스테로이드 치료 후 발생한 당뇨병성 케톤산증

• Published in: 당뇨병(JKD) Vol. 9; no. 2; pp. 140 - 144
• Main Authors: 신영철, Young Chul Shin, 유재명, Jae Myung Yu, 이해리, Hae Ri Lee, 우경희, Kyung Hee Woo, 류옥현, Ohk Hyun Ryu, 강준구, Jun Goo Kang, 김철식, Chul Sik Kim, 이병완, Byung Wan Lee, 이성진, Seong Jin Lee, 김현규, Hyeon Kyu Kim, 홍은경, Eun Gyoung Hon
• Format: Journal Article
• Language: Korean
• Published: 대한당뇨병학회 30.06.2008
• Subjects: Diabetic ketoacidosis; Steroid
• ISSN: 2233-7431

저자들은 당뇨병의 과거력이나 가족력이 전혀 없는 아토피성 피부염환자에서 장기간의 스테로이드 투여 후 급격한 고혈당, 심한 탈수로 인한 저혈량성 쇼크, 다기관 부전까지 발생하였으나 지속적 정정맥 혈액여과법 및 인슐린 치료 수일 후 현격하게 호전된 스테로이드 유발성 당뇨병성 케톤산증 1예를 경험하였기에 이에 보고하는 바이다. Long-term use of glucocorticoids can be a cause of diabetes mellitus, but diabetic ketoacidosis has been rarely described. A 29-year-old man visited our emergency room by symptoms of diabetic ketoacidosis. He has no past history or family history of diabetes mellitus, and has been treated for 3 years with steroid for atopic dermatitis. He showed drowsy mental status and severe hyperglycemia, and multiorgan dysfunction syndrome due to development of hypovolemic shock. After intensive insulin therapy with continuous venovenous hemofiltraion, he was recovered from ketoacidosis and multiorgan failure. Serum C-peptide and insulin level checked on admission was severely low, however those indices of insulin secretion capacity was normalized after admission 9th days. At present, he has stabilized glycemic control with metformin only. So, we report this rare case of diabetic ketoacidosis with review of articles.