A Case of Slowly Progressive Type 1 Diabetes Mellitus With Asymptomatic Myocardial Injury During Diabetic Ketoacidosis Treatment

DOI
  • Fujii Masanao
    Department of Endocrinology and Metabolism, Tsukuba University Hospital Mito Medical Center, Mito Kyodo General Hospital
  • Ito Kei
    Department of Endocrinology and Metabolism, Tsukuba University Hospital Mito Medical Center, Mito Kyodo General Hospital
  • Kumagai Ryo
    Department of Endocrinology and Metabolism, Tsukuba University Hospital Mito Medical Center, Mito Kyodo General Hospital
  • Katakura Yukino
    Department of Endocrinology and Metabolism, Tsukuba University Hospital Mito Medical Center, Mito Kyodo General Hospital
  • Muramatsu Aiko
    Department of Endocrinology and Metabolism, Tsukuba University Hospital Mito Medical Center, Mito Kyodo General Hospital
  • Oishi Yuta
    Department of Cardiology, Tsukuba University Hospital Mito Medical Center, Mito Kyodo General Hospital
  • Yagyu Hiroaki
    Department of Endocrinology and Metabolism, Tsukuba University Hospital Mito Medical Center, Mito Kyodo General Hospital

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Other Title
  • 糖尿病性ケトアシドーシス治療中に無症候性心筋障害を呈した緩徐進行1型糖尿病の1例

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<p>A 65-year-old man with slowly progressive type 1 diabetes mellitus (DM) was hospitalized with diabetic ketoacidosis (DKA). He underwent 19 hours of insulin therapy and hydration, and had no chest pain. However, electrocardiography (ECG) revealed ST elevation in leads I-III, aVF, V5 and V6. His serum creatine phosphokinase rapidly increased to 1,983 U/L and he was positive for troponin T. Coronary angiography (CAG) revealed diffuse hypokinesis of the left ventricle without coronary artery stenosis. The patient was finally diagnosed with asymptomatic myocardial damage due to viral infection and his serum phosphorus level rapidly fluctuated during treatment for DKA. We should pay attention to myocardial damage in patients without symptoms at the beginning of DKA treatment.</p>

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