洛拉提尼布治疗期间的糖尿病酸性:病例报告
Atsushi Yanagisawa1, Takayuki Shiroyama1, Kotaro Miyake1
1Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan.
概括
洛拉提尼布可以导致严重的高血糖,这是一个罕见但危险的副作用. 对于开始服用洛拉提尼布的糖尿病患者来说,密切的血糖监测至关重要,以预防糖尿病酸症 (DKA).
科学领域:
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 洛拉提尼布是一种性淋巴瘤激酶 (ALK) 抑制剂,用于治疗ALK阳性非小细胞肺癌.
- 超脂血症是已知的洛拉提尼布不良事件,但高血糖症不太常见,可能危及生命.
- 患有先前存在的糖尿病患者在洛拉提尼布治疗期间患有严重高血糖的风险增加.
研究的目的:
- 报告2型糖尿病患者中糖尿病酸症 (DKA) 的病例,患者接受了洛拉提尼布治疗.
- 强调在接受洛拉提尼布治疗的患者,特别是那些有先前存在的糖尿病患者中保持警的葡萄糖监测的重要性.
- 突出洛拉提尼布可能导致严重,危及生命的高血糖症.
主要方法:
- 一个65岁的男性患有ALK阳性肺癌和2型糖尿病的病例报告.
- 患者从alectinib转换为lorlatinib,经历了血糖控制的快速恶化.
- 治疗包括胰岛素治疗,暂时停止使用洛拉提尼布,然后在重新开始时降低剂量.
主要成果:
- 患者在开始服用洛拉提尼布后发展出糖尿病酸症 (DKA).
- 在洛拉提尼布治疗三个月内,糖化血红蛋白 (HbA1c) 水平从6%增加到11.5%.
- DKA通过胰岛素治疗和洛拉提尼布中断而消失;在重新开始时,允许降低剂量以获得令人满意的血糖控制.
结论:
- 洛拉提尼布可以在2型糖尿病患者中导致严重的高血糖和糖尿病酸性糖尿病 (DKA).
- 警的葡萄糖监测和主动管理对于服用洛拉提尼布的患者至关重要,特别是那些患有糖尿病的患者.
- 早期识别和干预可以预防与洛拉提尼布诱导的高血糖症相关的危及生命的并发症.
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