血糖急剧下降后的高血糖是后置可逆脑病综合征 (PRES) 的罕见原因
Liza Garabet Diramerian1, Nabila Ashraf1, Admir Syla1
1Department of Internal Medicine, Lewis-Gale Medical Center, Salem, VA.
HCA healthcare journal of medicine
|July 10, 2023
概括
后部可逆脑病综合征 (PRES) 可能是由快速的血糖变化引发的,而不仅仅是高血压. 这一案例突出了PRES的不常见原因,原因是葡萄糖的极端波动.
科学领域:
- 神经学 神经学
- 内分泌学 在内分泌学.
背景情况:
- 后部可逆脑病综合征 (PRES) 是一种神经疾病,其特征是头痛,混乱,视觉变化,和焦点神经缺陷.
- 神经成像通常显示后白质,通常与高血压有关.
研究的目的:
- 为了呈现出一种不寻常的PRES病例,这是由于葡萄糖水平的极端波动造成的.
- 讨论将葡萄糖失调与PRES联系起来的潜在机制.
主要方法:
- 一个49岁的女性患有糖尿病和高血压的情况报告.
- 分析了临床表现,实验室发现和脑MRI结果.
- 患者管理的重点是稳定血糖水平.
主要成果:
- 患者经历了PRES症状,包括视觉变化,血糖从700毫克/分升降到75毫克/分升.
- 大脑MRI证实了双侧尾叶的脱髓化病变,与PRES一致.
- 症状消失,避免了进一步的快速葡萄糖波动.
结论:
- 除了高血压之外,PRES还可能由其他原因引起,例如显著的葡萄糖水平变化.
- 早期诊断和管理PRES,无论病因,对于有利的结果至关重要.
- 这一案例强调了在PRES诊断中考虑代谢障碍的重要性.
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