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Publicado: 18 de mayo de 2010
ESTADO HIPEROSMOLAR EN PACIENTE DE 24 AÑOS DE EDAD CON SÍNDROME METABÓLICO, AGENESIA RENAL IZQUIERDA Y GLOMÉRULOESCLEROSIS DIABÉTICA DIFUSA
Castro R.X.; Espino B.D.; Ocampo M.J.; Romero H.M.Abstract:
The diabetes mellitus type 2 characterizes to be prevalent in patients with direct familiar antecedents of DM2, obesity with insulin resistance and in mature people. Thehyperglycemic-hyperosmolar nonketotic coma it´s a complication of bad treated patients with DM2 and advanced age. The characteristics of this pathology are hyperglycemia, hyperosmolarity and advanced dehydratation. Thepatient of the case is 24 years old previously diagnosed with DM2 and a previous HHNKC, uncommon in youth, it´s remarkable the non-dehydratation. This could be seen at the physical exploration thatrefers a good general state without characteristics of dehydratation, an arterial pressure of 140/70 mmHg, girdle circumference of 102 cm, a BMI of 30.5 and a weight of 86kg. The presumptive diagnosewas HHNKC without dehydratation. The laboratory results were: glycemia of 29.53 mmol/L, glycosylated, hemoglobin of 13.5%, triglycerides of 180mg/dl, HDL 38mg/dl, LDL 130mg/dl. The urine exam reportedglucosuria and oligoalbuminuria. At the renal ecography was seen agenesia of the left kidney. At the renal gammagraphy presented hyperfiltration. The renal biopsy demonstrated a diffuse diabeticglomeruloesclerosis. Because of the obtained results, the final diagnoses were metabolic symdrom, DM2, HHNKC, first state obesity, dislipidemia, left renal agenesia and renal insufficiency. The patient wastreated with 10IU of rapid-acting insulin and a hydric-replacement with a hypotonic solution (0.9%). One year later the patient presented the next laboratory results: glycosylated hemoglobin of 15.5%and proteinuria of 3.3g/24hrs.
Resumen:
La Diabetes Mellitus tipo 2 se caracteriza por presentarse prevalentemente en pacientes con antecedentes familiares directos de DM2, obesos con...
Castro R.X.; Espino B.D.; Ocampo M.J.; Romero H.M.Abstract:
The diabetes mellitus type 2 characterizes to be prevalent in patients with direct familiar antecedents of DM2, obesity with insulin resistance and in mature people. Thehyperglycemic-hyperosmolar nonketotic coma it´s a complication of bad treated patients with DM2 and advanced age. The characteristics of this pathology are hyperglycemia, hyperosmolarity and advanced dehydratation. Thepatient of the case is 24 years old previously diagnosed with DM2 and a previous HHNKC, uncommon in youth, it´s remarkable the non-dehydratation. This could be seen at the physical exploration thatrefers a good general state without characteristics of dehydratation, an arterial pressure of 140/70 mmHg, girdle circumference of 102 cm, a BMI of 30.5 and a weight of 86kg. The presumptive diagnosewas HHNKC without dehydratation. The laboratory results were: glycemia of 29.53 mmol/L, glycosylated, hemoglobin of 13.5%, triglycerides of 180mg/dl, HDL 38mg/dl, LDL 130mg/dl. The urine exam reportedglucosuria and oligoalbuminuria. At the renal ecography was seen agenesia of the left kidney. At the renal gammagraphy presented hyperfiltration. The renal biopsy demonstrated a diffuse diabeticglomeruloesclerosis. Because of the obtained results, the final diagnoses were metabolic symdrom, DM2, HHNKC, first state obesity, dislipidemia, left renal agenesia and renal insufficiency. The patient wastreated with 10IU of rapid-acting insulin and a hydric-replacement with a hypotonic solution (0.9%). One year later the patient presented the next laboratory results: glycosylated hemoglobin of 15.5%and proteinuria of 3.3g/24hrs.
Resumen:
La Diabetes Mellitus tipo 2 se caracteriza por presentarse prevalentemente en pacientes con antecedentes familiares directos de DM2, obesos con...
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