-
Case Report
-
Korean J Med. 2014;86(6):761-765. Published online June 1, 2014.
DOI: https://doi.org/10.3904/kjm.2014.86.6.761
- 전이성 신세포암에서 Everolimus 사용 후 유발된 당뇨병성 케톤산증 1예
-
김이경1, 안창호1, 이지은1, 정찬현1, 구보경1,2, 문민경1,2
-
1서울대학교 의과대학 내과학교실
2서울특별시 보라매병원 내과
- Case Report of Everolimus-Associated DKA in a Patient with Metastatic Renal Cell Carcinoma
-
Lee-Kyung Kim1, Chang Ho Ahn1, Jie Eun Lee1, Chan-Hyeon Jung1, Bo Kyung Koo1,2, Min Kyong Moon1,2
-
1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
2Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea
- Corresponding author: Min Kyong Moon ,Tel: +82-2-870-2226, Fax: +82-2-831-0714, Email: mkmoon@snu.ac.kr
- Received: December 22, 2013; Revised: January 6, 2014 Accepted: February 25, 2014.
- 신세포암, 유방암, 췌장의 신경내분비종 등의 치료에 사용이 증가하고 있는 mTOR 억제제인 everolimus의 치료 시 고혈당, 고지질혈증 등의 대사 이상이 발생할 수 있음이 알려져 있으나 당뇨병성 케톤산증의 발생은 보고된 바 없다. 저자들은 전이성 신세포암에서 everolimus 투여 후 발생한 당뇨병성 케톤산증 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
߽ɾ :Everolimus; 당뇨병성 케톤산증; 고혈당; 인슐린 저항성; 전이성 신세포암
- Abstract
- Everolimus, an inhibitor of the mammalian target of the rapamycin (mTOR) pathway, is widely used as an immunosuppressant for the prevention of organ rejection following transplant and to treat metastatic clear-cell type renal cell carcinoma (RCC), breast cancer, and pancreatic neuroendocrine tumors. Everolimus commonly induces metabolic abnormalities such as hyperglycemia, hypercholesterolemia, and hypertriglyceridemia due to concomitant increases in blood glucose levels via the induction of insulin resistance and a decrease in β cell function, which both lead to insulin deficiency. Although abnormal blood glucose levels are observed in more than 50% of patients treated with Everolimus, hyperglycemia exceeding 500 mg/dL is not common and there have been no reports of Everolimus-induced acute hyperglycemic crisis conditions. Here, a novel case of Everolimus-associated diabetic ketoacidosis (DKA) in a patient with RCC is reported. (Korean J Med 2014;86:761-765)
Keywords :Everolimus, DKA, Hyperglycemia, Insulin resistance, Metastatic renal cell carcinoma
