scholarly journals A Rare Case of Persistent Lactic Acidosis in the ICU: Glycogenic Hepatopathy and Mauriac Syndrome

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Kirsten S. Deemer ◽  
George F. Alvarez
Keyword(s):  
Diabetes Mellitus ◽  
Lactic Acidosis ◽  
Rare Case ◽  
Hemoglobin A1c ◽  
Blood Glucose Control ◽  
Primary Treatment ◽  
High Dose ◽  
Single Feature ◽  
Mauriac Syndrome

Mauriac syndrome is a rare disorder that can present with the single feature of glycogenic hepatopathy in children and adults with poorly controlled diabetes mellitus. An often underrecognized finding of glycogenic hepatopathy is lactic acidosis and hyperlactatemia. Primary treatment of glycogenic hepatopathy is improved long-term blood glucose control. Resolution of symptoms and hepatomegaly will occur with improvement in hemoglobin A1C. We present here a case of a young adult female presenting to the intensive care unit with Mauriac syndrome. This case demonstratesexacerbationof lactic acidosis in a patient with glycogenic hepatopathy treated for diabetic ketoacidosis with high dose insulin and dextrose.

scholarly journals Inappropriate Use of High-Dose Glyburide to Treat Uncontrolled Type 2 Diabetes Mellitus

1993 ◽  
Vol 27 (2) ◽  
pp. 161-166 ◽  
Author(s):  
Charlesworth E. Rae ◽  
Robert C. Ewing ◽  
Dee Dee Cook
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Blood Glucose Control ◽  
Blood Glucose Monitoring ◽  
High Dose ◽  
Secondary Failure ◽  
Sulfonylurea Drugs ◽  
Niddm Patients

Objective To report a case of chronic glyburide overdose. Case Summary A patient with noninsulin-dependent diabetes mellitus (NIDDM) who had previously developed secondary failure while taking a maximal dosage of glipizide was switched to glyburide 5 mg/d. The patient initially experienced adequate glycemic control while taking glyburide, but subsequently experienced deterioration in glycemic control. This necessitated gradual increases in the dosage of glyburide until the maximum dosage of 20 mg/d was reached. Because the patient's diabetic control did not improve with this dosage of glyburide, she decided independently to increase the dosage further. She ingested an average daily dose of 37.7 mg of glyburide over the 18 days that preceded her clinic visit without experiencing any glyburide-related adverse effects. Discussion Progression of NIDDM may be responsible for the development of secondary sulfonylurea failure in NIDDM patients treated with oral sulfonylurea drugs. Consequently, these patients should be treated as patients dependent on insulin. Conclusions NIDDM patients treated with oral sulfonylurea drugs require long-term blood glucose monitoring to detect the development of secondary sulfonylurea failure. Patients who experience secondary failure to a particular sulfonylurea drug do not appear to develop long-term blood glucose control when switched to a different oral sulfonylurea drug. These patients should be treated with insulin therapy.

scholarly journals Persistent lactic acidosis in the Mauriac syndrome in type 1 diabetes mellitus

2021 ◽  
pp. 1-2
Author(s):  
Abinash Subedi ◽  
Vishnu Charan Suresh Kumar ◽  
Anuj Sharma ◽  
Gilles Hoilat ◽  
Savio John
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Lactic Acidosis ◽  
Type 1 Diabetes Mellitus ◽  
Mauriac Syndrome

scholarly journals Primary sclerosing cholangitis and pregnancy

2011 ◽  
Vol 1 (3) ◽  
pp. 55 ◽  
Author(s):  
Casper Q. Kammeijer ◽  
Robert A. De Man ◽  
Christianne J.M. De Groot
Keyword(s):  
Ursodeoxycholic Acid ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Rare Case ◽  
Progressive Disease ◽  
High Dose ◽  
Term Outcome ◽  
Long Term Outcome ◽  
In Pregnancy

Primary sclerosing cholangitis is a progressive disease, and coincidentally in pregnancy it is rare. It is characterized by progressive inflammation and destruction of bile ducts finally resulting in liver failure. A rare case of primary sclerosing cholangitis in pregnancy is presented. The course of the pregnancy was marked by threatened preterm delivery and exacerbation of cholestasis. She was successfully treated with ursodeoxycholic acid (UDCA). Although, primary sclerosing cholangitis has both maternal and fetal effects on pregnancy, the overall outcome is favorable. Only few cases have been reported using high dose ursodeoxycholic acid for primary sclerosing cholangitis in pregnancy, it often improves pruritus but has no protection against stillbirth. Data on the safety to the fetus or neonate and long-term outcome are scarce.

The Revised High-Dose Regimen of Beacop in the Primary Treatment of the Advanced Hodgkin's Lymphoma: A Interim Report

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4783-4783
Author(s):  
Peng LIU ◽  
Yuankai Shi ◽  
Zhao Wang
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Standard Dose ◽  
Primary Treatment ◽  
Hodgkin's Lymphoma ◽  
High Dose ◽  
Similar Response ◽  
Good Tolerance ◽  
Asian Patients ◽  
Advanced Hodgkin’S Lymphoma

Abstract Abstract 4783 Objective In the study, we compared the efficacy between the revised high-dose and standard-dose of the revised BEACOP regimen (Bleomycin, Etoposide, Epidoxorubicin, Cyclophophamide, Vincristine, Prednisione) in the treatment of the advanced Hodgkin's lymphoma (HL). Patients and methods Patients with HL of Stage III/IV were 1:1 randomized into either the standard-dose BEACOP regimen (the same to the BEACOPP regimen in GHSG-HD9 study except procarbazine) in the control arm or the revised high-dose BEACOP regimen (different from BEACOPPesc regimen in GHSG-HD9 study, excluding procarbazine, increasing the dose of cyclophophamide and doxorubicin, with the standard-dose of etoposide, and without the preventive G-CSF support) in the experimental arm. Patients with large tumor or residual tumor after 6 to 8 cycles chemotherapy would be received local radiotherapy. All patients were evaluated by imaging examination every 2 cycles during treatment and were followed up every 3 months from the end of the treatment. Results 33 cases with advanced HL completed whole cycles chemotherapy and were followed-up a medium time of 12 months. The interim analysis showed that, patients received revised high-dose BEACOP had better response than those with standard-dose BEACOP. After 2 cycles chemotherapy, 2/17 cases had complete response (CR), and 8/17 cases had reduced more than 75% in the tumor size in the experimental arm; while none of 16 cases in the control arm achieved the similar response. After 6 cycles chemotherapy, 13/17 cases in the experimental arm achieved CR/CRu, compared with 8/16 cases in the control arm. Simultaneously, adverse drug reactions, such as neutropenia, nausea and vomiting, were observed significantly increased in the experimental arm. However, no related death and SAE occurred. All the patients showed good tolerance in the study. Conclusions In the HD9 study, asian patients received with BEACOPPesc were not tolerated enough to complete the whole chemotherapy, because of the serious toxicity such as long-term bone marrow suppression. In our study, we demonstrated that revised high-dose BEACOP in the primary treatment of the advanced HL would achieved the more high rate of CR/CRu compared with standard-dose BEACOP, and patients with revised high-dose BEACOP showed good tolerance and controllable acute hematotoxicity, even without the preventive use of G-CSF. Therefore, the revised high-dose BEACOP regimen might be a potential choice for Asian patients with advanced HL. However, more cases and long-term follow-up should be needed in the future to evaluate the long-term overall survival (OS) rate, efficacy and toxicity. Disclosures: LIU: Research Project of Cancer Hospital, CAMS: Research Funding.

Effects of Concomitant Administration of Sodium Glucose Co-transporter 2 Inhibitor with Insulin on Hemoglobin A1c, Body Mass Index and Serum Lipid Profile in Japanese Type 2 Diabetic Patients

Drug Research ◽  
2018 ◽  
Vol 68 (12) ◽  
pp. 669-672
Author(s):  
Masataka Kusunoki ◽  
Yukie Natsume ◽  
Tetsuro Miyata ◽  
Kazuhiko Tsutsumi ◽  
Yoshiharu Oshida
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Hemoglobin A1c ◽  
Blood Glucose Control ◽  
Sglt2 Inhibitor ◽  
Serum Triglyceride ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

AbstractIn patients with type 2 diabetes mellitus who show suboptimal blood glucose control under insulin therapy alone, concomitant treatment with an additional hypoglycemic agent that differs in its mechanism of action from insulin may be considered. We conducted this clinical trial to explore whether further control of increased blood glucose level can be achieved with concomitant use of sodium glucose co-transporter 2 (SGLT2) inhibitor as concomitant with other hypoglycemic therapy, as compared to SGLT2 inhibitor monotherapy, in patients with type 2 diabetes mellitus showing decrease in blood glucose level but less than the effect of insulin monotherapy and there was no significant differences. In the SGLT2 inhibitor monotherapy group, decreases of the serum hemoglobin A1c (HbA1c) level, body weight, body mass index (BMI) and serum triglyceride, and elevation of the serum high density lipoprotein cholesterol concentration were observed as compared to the baseline values. In the type 2 diabetic patients under insulin therapy who received combined insulin plus SGLT2 inhibitor therapy, however decreases in the body weight and BMI, with only a tendency towards decrease of the serum HbA1c value, not reaching statistical significance, were observed. The combined therapy group also showed no appreciable changes of the serum triglyceride level, while the serum adiponectin level increased. The present study data indicate that combined insulin plus SGLT2 inhibitor treatment failed to afford any further improvement of the blood glucose control, as compared to SGLT2 monotherapy, in Japanese type 2 diabetic patients.

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