L-asparaginase療法中に一過性糖尿病を来した急性骨髄性白血病の1小児例

藤田 克寿; 坂本 泉; 竹内 義博; 東道 伸二郎; 新川 正治; 今宿 晋作; 沢田 淳; 楠 智一; 三宅 宗隆; 小林 正

doi:10.11406/rinketsu.22.668

Transient Diabetes Mellitus Induced by L-asparaginase in a Patient with Acute Myeloblastic Leukemia

Katsutoshi FUJITA, Izumi SAKAMOTO, Yoshihiro TAKEUCHI, Sinjiro TODO, Shoji ARAKAWA, Sinsaku IMASHUKU, Tadashi SAWADA, Tomoichi KUSUNOKI, Munetaka MIYAKE, Masashi KOBAYASHI

Author information

Katsutoshi FUJITA
Department of Pediatrics, Kyoto Prefectural University of Medicine
Izumi SAKAMOTO
Department of Pediatrics, Kyoto Prefectural University of Medicine
Yoshihiro TAKEUCHI
Department of Pediatrics, Kyoto Prefectural University of Medicine
Sinjiro TODO
Department of Pediatrics, Kyoto Prefectural University of Medicine
Shoji ARAKAWA
Department of Pediatrics, Kyoto Prefectural University of Medicine
Sinsaku IMASHUKU
Department of Pediatrics, Kyoto Prefectural University of Medicine
Tadashi SAWADA
Department of Pediatrics, Kyoto Prefectural University of Medicine
Tomoichi KUSUNOKI
Department of Pediatrics, Kyoto Prefectural University of Medicine
Munetaka MIYAKE
Department of Pediatrics, Minami Osaka Hospital
Masashi KOBAYASHI
Third Department of Internal Medicine, Shiga University of Medical Science

Keywords: AML, L-asparaginase, diabetes mellitus, insulin receptor

JOURNAL RESTRICTED ACCESS

1981 Volume 22 Issue 5 Pages 668-672

DOI https://doi.org/10.11406/rinketsu.22.668

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Abstract

A 14 year-old-boy with acute myeloblastic leukemia developed diabetes mellitus while receiving therapeutic L-asparaginase. The insulin binding determined as the percentage of ¹²⁵I-insulin bound to his erythrocytes was found markedly decreased at the time of being diabetic and then gradually returned to normal with recovery.
By using erythrocytes from 3 more patients with acute leukemia, ¹²⁵I-insulin binding was also assayed before and after L-asparaginase treatment. Decrease of insulin binding induced by L-asparaginase was confirmed in these studies.
It is suggested that hyperglycemia induced by L-asparaginase could be caused by changes in the quantity of insulin receptor or in the affinity of these receptors for insulin.

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