A Case of 83-year-old Woman with Elderly-onset Type 1 Diabetes Mellitus Accompanied by Diabetic Chorea without Typical Imaging Findings

Suemaru Daigo, Ishizuka Takahiro, Hashida Tetsu, Nakamura Yasuko, Uehara Yutaka

doi:10.11213/tonyobyo.58.407

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Other Title

典型的画像所見を伴わない糖尿病性舞踏病を呈した83歳の高齢発症1型糖尿病の1例
症例報告典型的画像所見を伴わない糖尿病性舞踏病を呈した83歳の高齢発症1型糖尿病の1例
ショウレイホウコクテンケイテキガゾウショケンオトモナワナイトウニョウビョウセイブトウビョウオテイシタ 83サイノコウレイハッショウ 1ガタトウニョウビョウノ 1レイ

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Description

An 83-year-old woman was admitted to our hospital in an emergent condition due to involuntary movement of both upper limbs, gait disturbance, and somnolence. On admission, her consciousness corresponded to the level of E 3 V 5 M 6 of the Glasgow Coma Scale. She had no paralysis in her upper or lower limbs, and there were no abnormal findings on brain computed tomography (CT) or magnetic resonance imaging (MRI). She showed marked hyperglycemia (950 mg/dl) and a hemoglobin A1c level of 15.1 %, accompanied by ketoacidosis. Physiologic saline administration and continuous venous insulin infusion were started to treat diabetic ketoacidosis. After treatment, her blood glucose level decreased to below 300 mg/dl, and her involuntary movements completely disappeared. Her neurological symptoms were diagnosed as diabetic chorea due to the lack of abnormal findings on brain CT and MRI and because of her marked hyperglycemia. On the laboratory findings, the titer of anti-GAD antibody was high, and the excretion of urinary C-peptide was decreased (12.4 μg/day). She was diagnosed with elderly-onset type 1 diabetes mellitus, and treated with intensive insulin therapy. No recurrence of involuntary movements was observed during the course of her hospitalization.

Journal

Journal of the Japan Diabetes Society

Journal of the Japan Diabetes Society 58 (6), 407-412, 2015

THE JAPAN DIABETES SOCIETY

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