Steroide Bağlı Diyabetik Ketozis Gelişen Fokal Segmental Glomeruloskleroz Olgusu

Kortikosteroidler, glomerüler nefropatilerde ve böbrek transplantasyonunda yaygın olarak kullanılmaktadır. Steroidlerin uzun süreli kullanımına bağlı olarak ciddi yan etkiler görülmektedir. Diyabetik ketoasidoztablosu nadiren bildirilmektedir. Burada, Fokal Segmental Glomeruloskleroz nedeniyle yüksek doz steroid kullanırken diyabetik ketoasidozis gelişen ve steroid dozu azaltıldığında kan şekeri düzelen hasta sunulmuştur.

DIABETIC KETOSIS DUE TO STEROID USE IN A CASE OF FOCAL SEGMENTALGLOMERULOSCLEROSIS

Corticosteroids are commonly used drugs in the treatment of glomerular diseases and renal posttransplantation management. However, long-term use of systemic corticosteroids have substantial side effects. The association of diabetic ketoacidosis with the use of systemic corticosteroids is infrequently reported. We report a complication of diabetic ketoacidosis, associated with the use of high dose corticosteroid for the treatment of focal segmental glomerulosclerosis; which improved afterthe cessation of steroid therapy.

___

  • 1. YoshiW. EM, Buczkowski AK. Sim SM, Elliott TG, Scudaınore CH, Lcvin A, Tıldesley HD, Landsberg DN. Post-transplant diabetic ketoacidosis-ıı. possible coruıequcnce of immunosuppression with calcineurininhibitingagents. Tn.nsp1Iııt2000; 13: 69-72.
  • 2. Kcshııvarz R, Mousavi M, Hassan C. Diabetic ketoacidosis in a child on FK506 immunosuppression arter a liver transplıınt. Pediatr Emerg Can: 2002; 18: 22-24.
  • 3. Erııoy A, Ersoy C, Tekce H, YAVa.Scııoglu 1, Dilek K. Dia.betic ketoacidosis following devclopment of de nova diabetes in tenal transplant recipient associated with tııcrolimus. Transplıınt Proc 2004;36: 1407-1410.
  • 4. Toyonaga T, Kondo T,Miyamura N, Selrigami T, Sonoda K, Kodama S, Shinıkami A. Shİ1'otani T, Anki E. Sudden onset of diabetes with ketoacidosis in a patlent treated with FK506/tacrolimus. Diabetes fu:s Clin Ptact2002; 56:13-18.
  • 5. www.mdcoruıult.com (Cyclosporine, tacrolimus adverse reactions. MDConsult,Drugs).
  • 6. O~ Kaya.alp. Tıbbi Farmakoloji Rasyonel Tedavi Yönünden. Ankara: Hacettepe-Taş Kitapçılık, 11. Baskı, 2005: 1000-1100.
  • 7. Bernatd Schimmeı BP, Parke.r KL. Adenocoıticottopic hormone.In:Phannacologic basis of therapeutic. Hardınan JG, limited LE, 9tb. ed NewYork,Mc GmwHill İne, 1996; 1459-1486.
  • 8. David-Neto E, Lemos FC, Fa.del LM, Agena F, Sata MY, Coccuza. C, Percira LM, de Castto MC, Lando VS, Nahas WC, Ianhcz LE. The dynamics of glucose metabolism under calcineurin inhibitors in the first year aftcr renal transplantatlon in nonobcsc patients. Transplııntatlon 2007; 84: 50-55.
  • 9. Dundar B, Eren E, Oktern F, Dundar N, Tunc B, Canatan n Hyperosmolar non-ketotlc sytıdrome in a child associated with 1-ıı.sparaginase and prednisolone. Pediatt lnt 2007; 49: 256-257.
  • 10. Yang JY, Cui XL, He XJ Non-ketotlc hyperosmolar coma complicatlng steroid trea.tment in dıildhood nephrosis. Pediatr Nephrol 1995;9:621-622.
  • 11. Yoshioka K, Sa.ta T, Okada N, Ishii T, Imanishi M, Tanaka S, Kim T, Sugimoto T, Fujii S. Post-transplant diabetes with anti-glut:atnic acid decarboxykse antibody during tacrolimus therapy. Dia.bet.es Res Oin Ptact1998;42: 85-89.
  • 12. Agarwall DK, Jeloka T, Sharma AP, Sharma RK. Steroid induccd diabetes mellitus prescntingas diabctic ketoacidosis. Indian J.Ncphrol 2002; 12: 122-123.
  • 13. Iw.unoto T, Kagawa Y, Naito Y, Kuzuhııra S, Kojima M. Steroid induced diabetes mellituıı anıl re.la.ted risk fiı.ctors in patients with neurologic discases. Phatmacothctapy 2004; 24: 508-514.
  • 14. Banac S, PcrsiC M, Cvijovic K. Steroid diabetes in childrcn with Crohn disease. ActaMed Croatica2002; 56: 35-38.
  • 15. SpearML,Rceves G, Pearlman SA. Diabetic lretoacidosis after steroid administtation for bronchopulmonuydysplasia J Peı:inatol 1993; 13: 232-234.