{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1390282679880503296.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.11213/tonyobyo1958.47.439"}},{"identifier":{"@type":"NDL_BIB_ID","@value":"025098339"}},{"identifier":{"@type":"URI","@value":"http://id.ndl.go.jp/bib/025098339"}},{"identifier":{"@type":"URI","@value":"https://ndlsearch.ndl.go.jp/books/R000000004-I025098339"}},{"identifier":{"@type":"NAID","@value":"130004339023"}},{"identifier":{"@type":"NAID","@value":"10013777222"}},{"identifier":{"@type":"URI","@value":"https://search.jamas.or.jp/link/ui/2004266267"}}],"dc:title":[{"@language":"en","@value":"Type 2 Diabetes Mellitus with Lactic Acidosis and Acute Renal Failure Induced by Metformin Overdose in Suicide"},{"@value":"自殺目的でメトホルミンの多量内服後に乳酸アシドーシスと急性腎不全を発症した２型糖尿病の１例"},{"@language":"ja-Kana","@value":"ショウレイ ホウコク ジサツ モクテキ デ メトホルミン ノ タリョウ ナイフク ゴ ニ ニュウサン アシドーシス ト キュウセイ ジンフゼン オ ハッショウ シタ 2ガタ トウニョウビョウ ノ 1レイ"}],"dc:language":"ja","description":[{"type":"abstract","notation":[{"@language":"en","@value":"A 38-year-old man treated with oral metformin and insulin injection for type 2 diabetes mellitus since 5 years ago attempted on April 5, 2003, to kill himself by overdosing on metformin (26.25g) and was seen for nausea, vomiting, epigastralgia, and disturbance of consciousness.He was diagnosed with lactic acidosis and acute renal failure based on findings of elevated serum lactic acid (178.9 mg/d<I>l</I>), urea nitrogen (BUN)(128 mg/d<I>l</I>), and creatinine (11.8 mg/d<I>l</I>), and metabolic acidosis with a wide anion gap (anion gap 58.8, pH 7.219).Lactic acidosis and acute renal failure were improved by continuous hemodialysis filtration (CHDF) and intravenous fluid therapy.Diabetic control was improved by insulin therapy.After that, the patient was discharged.CHDF is recommended to treat metformin-induced lactic acidosis to maintain blood circulation."},{"@value":"症例は38歳, 男性. 10年前に近医にて糖尿病を指摘され, 5年前からメトホルミンとインスリンによる治療をうけていた. 2002 (平成14) 年8月以降, 当院で2型糖尿病, 糖尿病性腎症 (曲中クレアチニン値0.95mg/d<I>l</I>) と糖尿病性網膜症に対して治療を行っていた, 2003 (平成15) 年4月5日, 自殺目的でメトホルミン105錠 (26.25g) と睡眠薬を多量に内服しアルコールを多飲した. その後, 悪心, 嘔吐, 上腹部痛と意識障害が出現したため受診した. 高乳酸血症 (178.9mg/d<I>l</I>), 血中尿素窒素値 (128mg/d<I>l</I>) と血中クレアチニン値の上昇 (118mg/d<I>l</I>), anbngapの開大 (58.8) および代謝性アシドーシス (pH 7.219) の所見より乳酸アシド-シスおよび急性腎不全と診断し, 持続的血液濾過透析 (continuous hemodialysis filtration: CHDF) を施行した. 糖尿病に対してはインスリン療法を行った. その後, 血中クレアチニン値の低下と血糖値の改善を認め退院となった. 以上, 自殺目的でメトホルミンの多量内服後に乳酸アシドーシスと急性腎不全を発症した2型糖尿病患者の1例を報告した. この症例より, メトホルミンによる乳酸アシドーシスに対する治療には, 循環動態を安定に保てるCHDFを選択すべきであると考えた. また, 自殺目的でメトホルミンを多量に内服することがないように, 服薬状況の確認が必要であると考えた."}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410001204906199808","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000002288889"},{"@type":"NRID","@value":"9000258083270"},{"@type":"NRID","@value":"9000256601828"}],"foaf:name":[{"@language":"en","@value":"Iwai Hiroshi"},{"@language":"ja","@value":"岩井 博司"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Endocrinology, Metabolism, and Diabetes, Kinki University School of Medicine"},{"@language":"ja","@value":"近畿大学医学部内分泌・代謝・糖尿病内科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410001204906199811","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000002287101"},{"@type":"NRID","@value":"9000258083267"},{"@type":"NRID","@value":"9000256601834"}],"foaf:name":[{"@language":"en","@value":"Ohno Yasuhiro"},{"@language":"ja","@value":"大野 恭裕"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Endocrinology, Metabolism, and 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孝哲"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"近畿大学医学部内分泌・代謝・糖尿病内科"},{"@language":"en","@value":"Department of Endocrinology, Metabolism, and Diabetes, Kinki University School of Medicine"}]},{"@id":"https://cir.nii.ac.jp/crid/1410282679882680710","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000002289065"},{"@type":"NRID","@value":"9000256601832"}],"foaf:name":[{"@language":"en","@value":"Miyatake Toshiyuki"},{"@language":"ja","@value":"宮武 利行"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Endocrinology, Metabolism, and Diabetes, Kinki University School of Medicine"},{"@language":"ja","@value":"近畿大学医学部内分泌・代謝・糖尿病内科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410001204903496576","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000002286809"},{"@type":"NRID","@value":"9000258083274"},{"@type":"NRID","@value":"9000256601833"},{"@type":"NRID","@value":"9000255878253"}],"foaf:name":[{"@language":"en","@value":"Aoki Norihiko"},{"@language":"ja","@value":"青木 矩彦"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"近畿大学医学部内分泌・代謝・糖尿病内科"},{"@language":"en","@value":"Department of Endocrinology, Metabolism, and Diabetes, Kinki University School of Medicine"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"0021437X"},{"@type":"EISSN","@value":"1881588X"},{"@type":"NDL_BIB_ID","@value":"000000016715"},{"@type":"ISSN","@value":"0021437X"},{"@type":"LISSN","@value":"0021437X"},{"@type":"NCID","@value":"AN00166576"}],"prism:publicationName":[{"@language":"en","@value":"Journal of the Japan Diabetes Society"},{"@language":"ja","@value":"糖尿病"},{"@language":"ja","@value":"糖尿病"},{"@language":"en","@value":"Journal of the Japan Diabetes Society"}],"dc:publisher":[{"@language":"en","@value":"THE JAPAN DIABETES SOCIETY"},{"@language":"ja","@value":"一般社団法人 日本糖尿病学会"}],"prism:publicationDate":"2004","prism:volume":"47","prism:number":"6","prism:startingPage":"439","prism:endingPage":"445"},"url":[{"@id":"http://id.ndl.go.jp/bib/025098339"},{"@id":"https://ndlsearch.ndl.go.jp/books/R000000004-I025098339"},{"@id":"https://search.jamas.or.jp/link/ui/2004266267"}],"availableAt":"2004","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=%E4%B9%B3%E9%85%B8%E3%82%A2%E3%82%B7%E3%83%89%E3%83%BC%E3%82%B7%E3%82%B9","dc:title":"乳酸アシドーシス"},{"@id":"https://cir.nii.ac.jp/all?q=%E3%83%93%E3%82%B0%E3%82%A2%E3%83%8A%E3%82%A4%E3%83%89%E8%96%AC","dc:title":"ビグアナイド薬"},{"@id":"https://cir.nii.ac.jp/all?q=%E8%85%8E%E4%B8%8D%E5%85%A8","dc:title":"腎不全"},{"@id":"https://cir.nii.ac.jp/all?q=2%E5%9E%8B%E7%B3%96%E5%B0%BF%E7%97%85","dc:title":"2型糖尿病"}],"relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1360574094188524672","@type":"Article","relationType":["cites"],"jpcoar:relatedTitle":[{"@value":"Lactic Acidosis in Patients with Diabetes Treated with 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