Severe hyperkalemia in two patients with diabetes after cosyntropin administration.
Some patients with diabetes mellitus are at increased risk for the development of hyperkalemia. Included in this group are patients with glucose-induced hyperkalemia who may have renal insufficiency, hyporeninemic hypoaldosteronism, or other impediments to the release or action of aldosterone. In an unusual demonstration of this abnormality, two patients with diabetes, who form the basis of our report, became markedly hyperglycemic and hyperkalemic after cosyntropin administration. To our knowledge, this complication of adrenocorticotropic hormone (ACTH) stimulation testing has not been previously reported. It should therefore be emphasized that the use of cosyntropin as a diagnostic agent can provoke severe hyperglycemia and hyperkalemia in a susceptible subgroup of patients with diabetes mellitus.
Feuerstein
B L
BL
Department of Medicine, State University of New York SUNY, Health Science Center, Syracuse 13210.
Lebowitz
M R
MR
Blumenthal
S A
SA
Weinstock
R S
RS
D000450:Aldosterone / Q000097:blood*; D001794:Blood Pressure; D003366:Cosyntropin / Q000009:adverse effects*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D003928:Diabetic Nephropathies / Q000097:blood; D003929:Diabetic Neuropathies / Q000097:blood / Q000150:complications; D003930:Diabetic Retinopathy / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D006943:Hyperglycemia / Q000139:chemically induced*; D006947:Hyperkalemia / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood
D003366:Cosyntropin; D000450:Aldosterone; D011188:Potassium; D006854:Hydrocortisone