A Case of Fulminant Type 1 Diabetes Combined with Early Detected Rhabdomyolysis

Baek, Jong Ha; Lee, Kyeong Ju; Hahm, Jong Ryeal; Jung, Jung Hwa; Kim, Soo Kyoung; Chung, Soon Il; Jung, Tae Sik

doi:2010.11.1.79

J Korean Diabetes > Volume 11(1); 2010 > Article

Original Article

The Journal of Korean Diabetes 2010;11(1):79-85.
DOI: https://doi.org/10.4093/kcd.2010.11.1.79

조기에 발견된 횡문근융해를 동반한 전격성 제1형 당뇨병 1예

백종하, 이경주, 함종렬, 정정화, 김수경, 정순일, 정태식

A Case of Fulminant Type 1 Diabetes Combined with Early Detected Rhabdomyolysis

Jong Ha Baek, Kyeong Ju Lee, Jong Ryeal Hahm, Jung Hwa Jung, Soo Kyoung Kim, Soon Il Chung, Tae Sik Jung

Abstract

Fulminant type 1 diabetes is characterized by an abrupt onset, severe diabetic ketoacidosis at diagnosis and a relatively low HbA1c. Rhabdomyolysis is not uncommonly combined with diabetic ketoacidosis or hyperglycemic hyperosmolar coma. Rhabdomyolysis increases the development of acute renal failure and mortality of the patients with hyperglycemic diabetic emergency. A 34-year-old man presented with 2-days duration of oliguria, vomiting and lethargy. Formerly, he developed polyuria and flu-like symptoms such as generalized myalgia and headache for 7 days. Initial investigation showed metabolic acidosis (arterial pH 7.093, bicarbonate 5.1 mmol/L), severe hyperglycemia (glucose 1,576 mg/dL), a relatively low HbA1c (7.1%) and acute renal failure (blood urea nitrogen 77 mg/dL and creatinine 4.4 mg/dL). Both serum and 24-hour urine C-peptide levels were checked at very low range and islet autoantibody tests were all negative. Serum creatinine kinase was elevated to 2,397 U/L and urine myoglobin test was positive. The patient recovered from acute renal failure and rhabdomyolysis after fluid and insulin therapy. He discharged on admission 17th days and controlled diabetes by self injection of basal and bolus insulin. (Korean Clinical Diabetes J 11:79-85, 2010)

Key Words: Fulminant, Rhabdomyolysis, Type 1 diabetes mellitus