Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Streptococcal Toxic Shock Syndrome Presenting with Spontaneous Hypoglycemia in a Chronic Hemodialysis Patient: Pathophysiological Mechanisms
Naoya IGAKITomokazu MATSUDAYushi HlROTATakayuki KAWAGUCHIFumihiko TAMADATakeo GOTO
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2003 Volume 42 Issue 5 Pages 421-423

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Abstract

Hypoglycemia is fatal if associated with sepsis in endstage renal disease (ESRD) patients. We report a hemodialysis patient of Streptococcal toxic shock syndrome presenting with hypoglycemia. She was found to be severely hypoglycemic with a plasma glucose level of 16 mg/dl. Immunoreactive insulin levels were undetectable throughout the clinical course. Several factors including reduced renal gluconeogenesis, reduced hepatic glucose output and excessive peripheral glucose utilization may account for the hypoglycemia in this patient. In conclusion, we would like to draw attention to the fact that septic ESRD patients without diabetes are prone to develop profound hypoglycemia with serious consequences.
(Internal Medicine 42: 421-423, 2003)

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