TY - JOUR
T1 - Fulminant type 1 diabetes mellitus following acute pancreatitis and hypoglycemia with sequential imaging of the pancreas using computed tomography
T2 - A case report
AU - Miyagahara, Tsukasa
AU - Fujimori, Nao
AU - Oono, Takamasa
AU - Okamoto, Misato
AU - Sato, Naoichi
AU - Sonoda, Noriyuki
AU - Kohashi, Kenichi
AU - Ishigami, Kousei
AU - Ogawa, Yoshihiro
PY - 2019
Y1 - 2019
N2 - Wc herein report a rare case of fulminant type 1 diabetes mellitus (FT1DM) following acute pancreatitis and hypoglycemia, in which the pancreas was evaluated by serial computed tomography (CT). A 30-year-old male presented to a local hospital with a two-day history of abdominal pain and was diagnosed with acute pancreatitis based on elevated serum amylase and peripancreatic fluid collection on CT images. The patient developed sudden hypoglycemia (plasma glucose, 45mg/dL: serum C-peptide, 3.4ng/mL) the next day and hyperglycemia (plasma glucose, 250-480mg/dL) on admission day four. CT revealed a low attenuation area extending from the pancreatic head to the pancreatic tail. On admission day eight, he was referred to our hospital and diagnosed with FT1DM after he developed ketoacidosis immediately after hospitalization, with a plasma glucose level of 442mg/dL, hemoglobin Ale concentration of 5.7% and undetectable urinary C- peptide with a serum C-peptide level of O.lng/mL before and after intravenous glucagon loading. CT imaging revealed dramatic improvement at the time, and no pancreatic islets were detected in the pancreatic biopsy specimens.
AB - Wc herein report a rare case of fulminant type 1 diabetes mellitus (FT1DM) following acute pancreatitis and hypoglycemia, in which the pancreas was evaluated by serial computed tomography (CT). A 30-year-old male presented to a local hospital with a two-day history of abdominal pain and was diagnosed with acute pancreatitis based on elevated serum amylase and peripancreatic fluid collection on CT images. The patient developed sudden hypoglycemia (plasma glucose, 45mg/dL: serum C-peptide, 3.4ng/mL) the next day and hyperglycemia (plasma glucose, 250-480mg/dL) on admission day four. CT revealed a low attenuation area extending from the pancreatic head to the pancreatic tail. On admission day eight, he was referred to our hospital and diagnosed with FT1DM after he developed ketoacidosis immediately after hospitalization, with a plasma glucose level of 442mg/dL, hemoglobin Ale concentration of 5.7% and undetectable urinary C- peptide with a serum C-peptide level of O.lng/mL before and after intravenous glucagon loading. CT imaging revealed dramatic improvement at the time, and no pancreatic islets were detected in the pancreatic biopsy specimens.
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U2 - 10.11405/nisshoshi.116.161
DO - 10.11405/nisshoshi.116.161
M3 - Article
C2 - 30745554
AN - SCOPUS:85061353177
VL - 116
SP - 161
EP - 167
JO - Japanese Journal of Gastroenterology
JF - Japanese Journal of Gastroenterology
SN - 0446-6586
IS - 2
ER -