Cetoacidosisdiabética reversible con metotrexato: Resistencia al tratamiento insulínico. Caso clínico

We report a 42 year-old woman with a hypothyroidism and a mixed connective tissue disease treated with prednisone and methotrexate. The patient had normal blood glucose levels but when the methotrexate dose was tapered, she presented a diabetic ketoacidosis that required up to 520 units of insulin p...

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Autores principales:	Novik A,Victoria, Vega S,Jorge, Carreño P,Verónica, Lagos G,Macarena
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2007
Materias:	Diabetic ketoacidosis Mixed connective tissue disease Methotrexate
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100012
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spelling	oai:scielo:S0034-988720070001000122014-01-06Cetoacidosisdiabética reversible con metotrexato: Resistencia al tratamiento insulínico. Caso clínicoNovik A,VictoriaVega S,JorgeCarreño P,VerónicaLagos G,Macarena Diabetic ketoacidosis Mixed connective tissue disease Methotrexate We report a 42 year-old woman with a hypothyroidism and a mixed connective tissue disease treated with prednisone and methotrexate. The patient had normal blood glucose levels but when the methotrexate dose was tapered, she presented a diabetic ketoacidosis that required up to 520 units of insulin per day. Due to the intensification of the mixed connective tissue disease symptoms, the doses of methotrexate and prednisone were increased again with a simultaneous normalization of serum glucose levels and glucose tolerance. In the following six months, when the dose of methotrexate was tapered again, the hyperglycemia reappeared and was again controlled increasing the dose. Thirty months after the episode of keotacidosis, the patient was with a weekly dose of methotrexate, asymptomatic and with a normal glucose tolerance. Anti insulin antibodies were not detected and anti islet antibodies were indeterminate, due to interference with antinuclear antibodies. It is possible that the episode of ketoacidosis was unveiled by an autoimmune phenomenoninfo:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.135 n.1 20072007-01-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100012es10.4067/S0034-98872007000100012
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Diabetic ketoacidosis Mixed connective tissue disease Methotrexate
spellingShingle	Diabetic ketoacidosis Mixed connective tissue disease Methotrexate Novik A,Victoria Vega S,Jorge Carreño P,Verónica Lagos G,Macarena Cetoacidosisdiabética reversible con metotrexato: Resistencia al tratamiento insulínico. Caso clínico
description	We report a 42 year-old woman with a hypothyroidism and a mixed connective tissue disease treated with prednisone and methotrexate. The patient had normal blood glucose levels but when the methotrexate dose was tapered, she presented a diabetic ketoacidosis that required up to 520 units of insulin per day. Due to the intensification of the mixed connective tissue disease symptoms, the doses of methotrexate and prednisone were increased again with a simultaneous normalization of serum glucose levels and glucose tolerance. In the following six months, when the dose of methotrexate was tapered again, the hyperglycemia reappeared and was again controlled increasing the dose. Thirty months after the episode of keotacidosis, the patient was with a weekly dose of methotrexate, asymptomatic and with a normal glucose tolerance. Anti insulin antibodies were not detected and anti islet antibodies were indeterminate, due to interference with antinuclear antibodies. It is possible that the episode of ketoacidosis was unveiled by an autoimmune phenomenon
author	Novik A,Victoria Vega S,Jorge Carreño P,Verónica Lagos G,Macarena
author_facet	Novik A,Victoria Vega S,Jorge Carreño P,Verónica Lagos G,Macarena
author_sort	Novik A,Victoria
title	Cetoacidosisdiabética reversible con metotrexato: Resistencia al tratamiento insulínico. Caso clínico
title_short	Cetoacidosisdiabética reversible con metotrexato: Resistencia al tratamiento insulínico. Caso clínico
title_full	Cetoacidosisdiabética reversible con metotrexato: Resistencia al tratamiento insulínico. Caso clínico
title_fullStr	Cetoacidosisdiabética reversible con metotrexato: Resistencia al tratamiento insulínico. Caso clínico
title_full_unstemmed	Cetoacidosisdiabética reversible con metotrexato: Resistencia al tratamiento insulínico. Caso clínico
title_sort	cetoacidosisdiabética reversible con metotrexato: resistencia al tratamiento insulínico. caso clínico
publisher	Sociedad Médica de Santiago
publishDate	2007
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100012
work_keys_str_mv	AT novikavictoria cetoacidosisdiabeticareversibleconmetotrexatoresistenciaaltratamientoinsulinicocasoclinico AT vegasjorge cetoacidosisdiabeticareversibleconmetotrexatoresistenciaaltratamientoinsulinicocasoclinico AT carrenopveronica cetoacidosisdiabeticareversibleconmetotrexatoresistenciaaltratamientoinsulinicocasoclinico AT lagosgmacarena cetoacidosisdiabeticareversibleconmetotrexatoresistenciaaltratamientoinsulinicocasoclinico
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Cetoacidosisdiabética reversible con metotrexato: Resistencia al tratamiento insulínico. Caso clínico

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