asbryobvrz
ORANGE EKSTRAKLASA
Dołączył: 21 Lut 2011
Posty: 441
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Wysłany: Śro 15:56, 23 Mar 2011 |
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Thyroid disease in 3 cases with diabetes ketoacidosis
Acid hydrogen roots 12.8mmol / L, urine was strongly positive (thirty),[link widoczny dla zalogowanych], positive urine ketone (++). One hospital diagnosis of hyperthyroidism with type 2 diabetic ketoacidosis. Treatment: give a lot of fluid, insulin lowers blood sugar, Yanbian University Medical antithyroid treatment of 28 September 2005 No. 3 therapy to correct acidosis and electrolyte imbalance, and to give increased leukocyte receptor blockers and drugs and so on. 10d significant improvement in symptoms and signs, blood glucose, serum potassium and blood bicarbonate Dengjun back to normal, blood ketone negative,[link widoczny dla zalogowanych], discharged. Case 3 patients, female, 53 years old, because of abdominal pain, diarrhea and fever ld, nausea, vomiting and unconsciousness 2h, at 20 March 2005 were hospital emergency department. The patient began 3 years ago edema, chills, alopecia, constipation,[link widoczny dla zalogowanych], nausea and memory loss and other obvious symptoms, a year ago began to polyuria, thirst, polydipsia, and fatigue and other symptoms, has intermittently taking pain tablets are . Clinical manifestations: the body temperature is 38.8 ℃,[link widoczny dla zalogowanych], blood pressure 80/50mmHg, heart rate of 65 times / min, pale coma, generalized edema mucus, rough skin, obvious goiter, low heart sound blunt, heart rate Qi. Laboratory examination: T is 0.9nmol / L, T4 is lower than 25.8nmol / L, TSH is 60.0mU / L, TG-Ab was 2.5, TM-Ab 2.3, random blood sugar was 29. 0mmol / L, serum bicarbonate was 12.0mmol / L, serum potassium was 2.6mmol / L, serum sodium was 128.0mmol / L, serum chloride was 95.0mmol / L. AGED hypothyroidism diagnosed with type 2 diabetes ketoacidosis. Treatment: give a lot of fluid replacement, correction of acidosis and electrolyte system disorder, hypoglycemic and symptomatic treatment, while providing a fun alternative and superior insulation and other treatment. 21d symptoms and signs improved, the test indexes returned to normal, discharged. 2 discussion Hyperthyroidism and diabetes are wasting metabolic diseases,[link widoczny dla zalogowanych], clinical manifestations have in common, early symptoms of light are not typical, if hyperthyroidism on the basis of diabetes, offenders are usually not typical symptoms of diabetes , weight loss, diarrhea, and sweating and other symptoms are often mistaken by the thyroid gland caused by hyperthyroidism], 219 * result in misdiagnosis due to easy, it led to serious complications such as ketoacidosis. Most patients with hypothyroidism occult onset, slow development, and sometimes years before the typical performance, if the diabetes, we often cover up the syndrome, diabetes, metabolic disorders, ie diabetes, the typical , diabetes, high blood pressure caused by swelling caused by the often mistaken for hypothyroidism caused by [, therefore, the blood in patients with thyroid disease should FPG and 2h postprandial blood glucose monitoring, early detection of diabetes, its complications and to avoid development. Similarly, asymptomatic patients with diabetes should also note the presence of thyroid dysfunction]. Hyperthyroidism associated with diabetes in hyperthyroidism may J3 cell function in patients with impaired insulin and thyroid hormone secretion caused by the increase in intestinal absorption of glucose increases glucose utilization in peripheral tissues leading to reduced blood sugar. Hypothyroidism and diabetes have common immunological basis of hypothyroidism in patients with diabetes, autoimmune reaction genetic defects, genetic predisposition and immune destruction of the balance between the overlap. In summary, thyroid disease, diabetes, the symptoms often not typical, but her condition is more serious, and should be alert to the possibility of coexistence of the two diseases, so that early diagnosis and also treatment, and thyroid function should be monitored regularly, and blood glucose to prevent complications. [
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