一个罕见的梅特福林诱导的乳酸和同时发生的优糖性酸的罕见病例
1Internal Medicine, Wright State University, Dayton, USA.
Cureus
|December 16, 2024
概括
甲福明很少会导致严重的乳酸和酸,特别是在末期脏疾病 (ESRD) 的患者中. 这一案例突显了甲胺的重要意义.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 毒理学 毒理学 毒理学
- 内部医学 内部医学
背景情况:
- 代谢性酸血是由于二碳酸盐的损失或二氧化碳的积累导致的,这可能导致致命的pH失衡.
- 阴离子间隙代谢酸性化可能源于乳酸或酸的积累,药物诱导的原因是显著的.
- 甲胺诱导的乳酸性酸症是已知的,但很少见;甲胺诱导的酸性酸症描述较少.
研究的目的:
- 在患有末期脏疾病 (ESRD) 的患者中报告严重的阳离子代谢酸性瘤病例,这种病例可能是由甲胺诱导的.
- 调查甲福明在诱导乳酸和酸的作用.
主要方法:
- 案例报告的呈现方式.
- 分析患者的新陈代谢状态,包括乳酸和水平.
- 复查梅特福林已知的并发症和潜在的代谢途径.
主要成果:
- 一名接受甲福明治疗的ESRD患者患有严重的阳离子间隙代谢酸症.
- 发现乳酸和的含量高得无法检测.
- 临床表现强烈表明甲福明在诱导乳酸和酸的作用.
结论:
- 甲福明可能会诱导严重的乳酸和酸,特别是在功能受损的患者中.
- 这一案例凸显了考虑甲福明作为严重酸性疾病的潜在原因以及乳酸性酸性疾病的重要性.
- 需要进一步研究梅特福林在ESRD患者的代谢作用.
相关概念视频
Inborn Errors of Metabolism
127
Phenylketonuria (PKU) is a protein metabolism disorder characterized by high blood levels of the amino acid phenylalanine. This results from a mutation in the gene responsible for phenylalanine hydroxylase, an enzyme that converts phenylalanine into tyrosine. When this enzyme is deficient, phenylalanine builds up in the blood, leading to symptoms such as vomiting, rashes, seizures, growth deficiency, and severe mental retardation. An early diagnosis and a diet restricting phenylalanine intake...
127
Oral Hypoglycemic Agents: Biguanides and Glitazones
168
Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
168
Hypoglycemia and Glucagon
150
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
150
Pathophysiology of Diabetes
862
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
862
Diabetes Mellitus: Type 2 and Gestational
2.2K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.2K
Diabetes: Symptoms, Diagnosis, and Complications
503
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
503


