Ketoacidosis in a boy with idiopathic membranous nephropathy during combined therapy with tacrolimus and low-dose prednisone
10.3760/cma.j.issn.1008-5734.2014.05.016
- VernacularTitle:他克莫司联合小剂量泼尼松治疗儿童特发性膜性肾病致酮症酸中毒
- Author:
Huijuan ZHANG
1
;
Qingyin GUO
1
;
Xianqing REN
1
;
Wensheng ZHAI
1
;
Ying DING
1
Author Information
1. 河南中医学院第一附属医院儿科, 郑州,450000
- Publication Type:Journal Article
- Keywords:
Tacrolimus;
Prednisone;
Ketoacidosis
- From:
Adverse Drug Reactions Journal
2014;(5):304-305
- CountryChina
- Language:Chinese
-
Abstract:
An 8-year-old boy received concomitant treatment with tacrolimus 1. 25 mg every 12 hours and prednisone 12. 5 mg once every other day for idiopathic membranous nephropathy. Five weeks later,the boy developed polydipsia,polyuria,vomiting,somnolence,and dehydration. Laboratory tests showed the following values:fasting plasma glucose 22. 4 mmol/L,blood pH 7. 24,standard bicarbonate 12 mmol/L,and urine ketone bodies( +++). The patient was diagnosed with ketoacidosis. Tacrolimus was stopped and he was treated with fluid supplementation 2 125 ml/d and continuous IV infusion of recombinant human insulin 2. 5 U/h. After 10 hours,laboratory results indicated that blood pH was 7. 40,fasting plasma glucose was 8. 5 mmol/L,and detection of urine ketone was negative for two times in a row. Then,his treatment was switched to subcutaneous injection of recombinant human insulin 6. 25 U before three meals. After 3 weeks,the fasting plasma glucose was 5. 9 mmol/L.
