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[Myoglobinuric renal failure in hyperosmolar diabetic coma (author's transl)]
Deutsche Medizinische Wochenschrift (1946)
|May 29, 1981
Summary
A rare case of acute rhabdomyolysis and kidney failure occurred in a woman with hyperosmolar non-ketotic diabetic coma. Insulin treatment may have triggered this condition by causing hypophosphatemia.
Area of Science:
- Nephrology
- Endocrinology
- Metabolic Disorders
Background:
- Hyperosmolar non-ketotic diabetic coma is a serious complication of diabetes mellitus.
- Acute rhabdomyolysis, characterized by muscle breakdown, can lead to acute kidney injury.
- Myoglobinuria, the presence of myoglobin in urine, is a hallmark of rhabdomyolysis.
Observation:
- A 66-year-old woman presented with hyperosmolar non-ketotic diabetic coma.
- She developed acute rhabdomyolysis with myoglobinuric renal failure during treatment.
- This complication manifested specifically under insulin therapy.
Findings:
- Elevated serum creatine kinase and myoglobin levels were observed.
- Massive myoglobinuria and acute renal failure were present.
- Rhabdomyolysis fully manifested during insulin treatment, suggesting a link.
Implications:
- Insulin-induced hypophosphatemia may be a causative factor in this case of rhabdomyolysis.
- This case highlights a potential, previously undescribed complication of managing diabetic coma.
- Further research is needed to understand the relationship between insulin, hypophosphatemia, and rhabdomyolysis in diabetic patients.