糖尿病性ケトアシドーシスで発症し、横紋筋融解症と各種膵酵素の上昇を示した成人発症IDDMの1例

Abstract

A 57-year-old man with no history of diabetes mellitus was admitted to our hospital because of malaise and impaired consciousness level. The laboratory findings on admission were as follows : plasma glucose 1, 181mg/dl, urine ketone bodies (+), serum amylase 1, 137IU/l, and serum lipase 400IU/l. Elevation of myogenic enzyme, serum-and urine-myoglobin were also observed, so we made a diagnosis of rhabdomyolysis. His diabetes mellitus was well controlled and his general condition improved after saline transfusion and insulin injection. Plasma CPR levels were not detected during admission, and no endogenous insulin secretion was observed on a glucagon tolerance test. These findings suggest that this case is IDDM in spite of his advanced age associated with rhabdomyolysis and elevation of serum pancreatic enzyme levels.