TY - JOUR
T1 - Hyperosmolar nonketotic hyperglycemic coma induced by methylprednisolone pulse therapy for acute rejection after liver transplantation
T2 - A case report and review of the literature
AU - Zhou, Jian
AU - Ju, Weiqiang
AU - Yuan, Xiaopeng
AU - Zhu, Xiaofeng
AU - Wang, Dongping
AU - He, Xiaoshun
N1 - Publisher Copyright:
© 2015 Feussner et al.
Copyright:
Copyright 2015 Elsevier B.V., All rights reserved.
PY - 2014/12/22
Y1 - 2014/12/22
N2 - Hyperosmolar nonketotic hyperglycemic coma (HNKHC) is a serious, rare complication induced by methylprednisolone (MP) pulse therapy for acute rejection after orthotopic liver transplantation (OLT). Herein, we report an unusual case of a 58-year-old woman who experienced acute rejection at 30 months after OLT, only one case in which HNKHC resulted in MP pulse therapy for acute rejection in all 913 recipients in our center. The general morbidity of HNKHC was 1.09‰ in this study. HNKHC is characterized by rapid onset, rapid progression, and a lack of specific clinical manifestations. High-dose MP management was a clear risk factor. The principle of treatment included rapid rehydration, low-dose insulin infusion, and correcting disorders of electrolytes and acidosis. In conclusion, clinicians considering MP pulse therapy after OLT should be alert to the occurrence of HNKHC.
AB - Hyperosmolar nonketotic hyperglycemic coma (HNKHC) is a serious, rare complication induced by methylprednisolone (MP) pulse therapy for acute rejection after orthotopic liver transplantation (OLT). Herein, we report an unusual case of a 58-year-old woman who experienced acute rejection at 30 months after OLT, only one case in which HNKHC resulted in MP pulse therapy for acute rejection in all 913 recipients in our center. The general morbidity of HNKHC was 1.09‰ in this study. HNKHC is characterized by rapid onset, rapid progression, and a lack of specific clinical manifestations. High-dose MP management was a clear risk factor. The principle of treatment included rapid rehydration, low-dose insulin infusion, and correcting disorders of electrolytes and acidosis. In conclusion, clinicians considering MP pulse therapy after OLT should be alert to the occurrence of HNKHC.
KW - Complications
KW - Hyperosmolar nonketotic hyperglycemic coma
KW - Liver transplantation
KW - Methylprednisolone pulse therapy
KW - Principle of treatment
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U2 - 10.2147/TRRM.S69516
DO - 10.2147/TRRM.S69516
M3 - Article
AN - SCOPUS:84919795959
SN - 1179-1616
VL - 7
SP - 23
EP - 26
JO - Transplant Research and Risk Management
JF - Transplant Research and Risk Management
ER -