长期使用类固醇和阿片类药物的年轻女性的可逆性脑病变的超大胞性高血糖状态:一个病例报告
11st Propaedeutic Internal Medicine Department, American Hellenic Educational Progressive Association (AHEPA) University Hospital, Thessaloniki, GRC.
Cureus
|January 16, 2026
概括
在年轻的成年人中,超的高血糖状态 (HHS) 是罕见的. 这一案例表明,HHS可以发生在慢性类固醇和阿片类药物使用中,特别是在肥胖患者中.
科学领域:
- 内分泌学 在内分泌学.
- 代谢障碍 代谢障碍 代谢障碍
- 神经科学是一个神经科学.
背景情况:
- 超的高血糖状态 (HHS) 通常在患有2型糖尿病的老年人中观察到.
- 年轻人很少发展HHS,其发生可能表明代谢条件和药物之间的复杂相互作用.
- 长期暴露于葡萄糖皮质类药物和阿片类药物可以显著影响代谢和内分泌功能.
研究的目的:
- 报告一个年轻成年人患有多种并发症和暴露的HHS病例.
- 突出非典型患者群体中HHS的诊断挑战和管理.
- 强调慢性葡萄皮质激素和阿片类药物使用在导致HHS的作用.
主要方法:
- 一个22岁的女性患有病态肥胖,异常性内高血压和慢性葡萄皮质激素和阿片类药物暴露的病例报告.
- 临床表现包括严重的高血糖,脱水,头痛和混乱.
- 实验室分析显示显著的高血糖,高度,保存的C-,抑制的ACTH/皮质醇和微量.
主要成果:
- 患者呈现的葡萄糖为583 mg/dL,度为318 mOsm/kg,与HHS一致.
- 保存的C-表明严重的胰岛素耐药性,而抑制的荷尔蒙表明外源性类固醇效应.
- 患者通过静脉注射液体,胰岛素,感染治疗和类固醇逐渐减少,完全康复.
结论:
- HHS可以发生在年轻人身上,特别是那些肥胖和长期暴露于类固醇和阿片类药物的年轻人.
- 这一案例强调了在涉及代谢和神经内分泌干扰的非典型表现中考虑HHS的重要性.
- 早期识别和管理对于预防严重并发症和确保神经系统恢复至关重要.
相关概念视频
01:15Hypoglycemia and Glucagon
838
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...
838
01:22Diabetes Mellitus: Type 2 and Gestational
4.3K
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...
4.3K
01:16Insulin: Dosing Regimen and Adverse Effects
689
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
689
01:14SBAR II: Application of SBAR
5.7K
SBAR is an effective communication tool used by healthcare professionals to communicate patient information accurately. SBAR stands for Situation, Background, Assessment, and Recommendation. For a better understanding, an example is given below.
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
5.7K
01:30Acute Pancreatitis II: Clinical Manifestations and Management
762
Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
762
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
439
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
439