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당뇨병성신증 환자에서 Fenoverine에 의해 발생한 횡문근융해증 1예
김기훈,심미령,계영하,이명수,박병현,안선호,오석규,김태현,송주흥,조정구 대한내과학회 2002 대한내과학회지 Vol.62 No.4
Fenoverine is a non-atropine like spasmolytic drug that inhibits calcium channel currents in the smooth muscle. It has been occassionally reported that fenoverine can cause rhabdomyolysis under the certain conditions such as hepatic dysfunction, concomitant use of HMG-CoA reductase, mitochondrial myopathy, lipid storage myopathy or malignant hyperthermia. However, there is no report of fenoverine-induced rhabdomyolysis in type 2 diabetic nephropathy patient. So we describe here a case of fenoverine-induced rhabdomyolysis in type 2 diabetic patient. A 70-year-old man had both lower legs and shoulder pain for 5 days prior to hospital admission. He was a type 2 diabetic patient and had been managed for diabetic nephropathy. He had been consumed common doses of fenoverine for 20 days due to abdominal pain and diarrhea. Results of investigations showed evidence of rhabdomyolysis. Fenoverine therapy was stopped after admission and he was treated supportive care, his condition was recovered. In this case, renal function impairment may have been a predisposing factor for fenoverine-induced rhabdomyolysis. The incidence of muscular complications of fenoverine therapy could be reduced by avoidance of prescription of the drug in patients with diabetic nephropathy.(Korean J Med 62:465-468, 2002) Fenoverine에 의한 횡문근융해증의 발생은 간질환의 존재나 HMG-CoA 환원효소 억제제 계열의 지질강하제 복용시 잘 발생한다고 알려져 있으나 당뇨병성신증 환자에서 fenoverine에 의한 횡문근융해증은 보고된바 없다. 이에 저자들은 당뇨병성신증 환자에서 fenoverine에 의한 횡문근융해증 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
김기훈,최지훈,계영하,장근영,김지웅,김태현,김경희,박병현,형근영,조정구 대한당뇨병학회 2000 임상당뇨병 Vol.1 No.1
Diabetics are predisposed to certain acute mononeuropathies, including a cranial neuropathy involving ocular motor nerves. Oculomotor nerve palsy is the most common cranial neuropathy in diabetes mellitus. Affection of several nerves in one eye can occur, rarely. Such as, the third and the sixth or the third and the fourth. The clinical characteristics of diabetes-associated ophathalmoplegia include abrupt onset, frequent occurrence of short-lived ipsilateral pain, sparing of pupillary reflex, resolution in most cases within a few months. Clinicopathological studies have suggested that diabetic ophathalomoplegia results from microvascular ischemia of an oculomotor nerve in its subarachnoid, cavernous segment or mid brain. Pupillary sparing is a single feature of diabetic third nerve palsy, and it has been widely used to distinguish diabetic oculomtor palsy from extrinsic compressive lesion of the third nerve, such as an aneurysm in the carotid siphon. No specific treatment is necessary. We experienced two cases of diabetic spontaneous ophthalmoplegia, one affected oculomotor nerve and the other affected partially oculomotor nerve and trochlear nerve, so we report these cases with review of the literatures.