Kosin Medical Journal

Case reports

Central diabetes insipidus following COVID-19 mRNA vaccination: a case report: Min-Young Kim, Jong Ryeal Hahm, Jaehoon Jung, Jung Hwa Jung, Kyoung Young Kim, Hosu Kim, Jong Ha Baek, Hwa Seon Shin, Kee Ryeon Kang, Soo Kyoung Kim; Kosin Med J. 2023;38(3):219-223. Published online June 9, 2023; DOI: https://doi.org/10.7180/kmj.23.105

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Abstract PDF PubReader ePub: The coronavirus disease 2019 (COVID-19) has been a major public health emergency worldwide. Vaccines were rapidly developed and approved to prevent the spread of viral infection. However, various side effects of the COVID-19 messenger RNA (mRNA) vaccines have been reported after their commercialization. A 24-year-old man visited our emergency department with polyuria and polydipsia that occurred after he received a COVID-19 mRNA vaccine 10 days beforehand. The initial laboratory findings showed very low urine osmolality with hyperosmolar hypernatremia. Based on these findings, diabetes insipidus was suspected, and sella magnetic resonance imaging showed an enlarged pituitary gland and the absence of posterior pituitary higher intensity. After 12 hours of using oral desmopressin acetate, urine volume decreased, and after 5 days of administration, serum electrolyte and serum osmolality improved. This case report of diabetes insipidus occurring after vaccination with the BNT162b2 mRNA COVID-19 vaccine is presented as a reminder that close monitoring is necessary for patients with polyuria and polydipsia after vaccination.

A case of intra-abdominal abscess caused by unconsciously ingestion of fish bone in elderly patient: Bo Ra Kim, Hong Jun Kim, Jong Ryeal Hahm, Chang Yoon Ha, Woon Tae Jung, Ok Jae Lee; Kosin Med J. 2018;33(3):415-421. Published online December 31, 2018; DOI: https://doi.org/10.7180/kmj.2018.33.3.415

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Cases showing complications such as esophageal injury, deep neck infection, and mediastinitis caused by accidental ingestion of fish bone are common. But ingestion of fish bone rarely causes perforation of the gastrointestinal tract or an intra-abdominal abscess.

We report herein a case of a 78-year-old man with a periumbilical mesenteric abscess caused by fish bone which was ingested unconsciously. The fish bone was found in the terminal ileum and it was removed by colonoscopy. The patient improved and he was discharged after systemic antibiotic therapy. Occasionally, when patients swallow fish bone without a foreign body sensation, clinicians should suspect perforation caused by fish bone in case of an intra-abdominal abscess of unknown cause.

A Case of Cerebral Venous Thrombosis in a Patient with Graves' Disease: Bo Ra Kim, Jung Hwa Jung, Jong Ryeal Hahm, Jaehoon Jung, Hee Jung Park, Soo Kyoung Kim; Kosin Med J. 2016;31(2):179-183. Published online January 20, 2016; DOI: https://doi.org/10.7180/kmj.2016.31.2.179

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Abstract PDF PubReader ePub

Abstract

Superior sagittal sinus thrombosis is an uncommon disease, and 25% of cases are considered to be idiopathic. Hypercoagulability, local bloodstream stasis, and vessel wall abnormalities may contribute to the development of this condition. The thyrotoxic phase of Graves' disease is associated with venous thrombosis caused by hypercoagulability, which is in turn induced by increased levels of homocysteine and factor VIII and decreased fibrinolytic activity. Here, we report the case of a 39-year-old male who presented with superior sagittal sinus thrombosis and concomitant hyperthyroidism.

Citations

Citations to this article as recorded by

Cerebral Venous Thrombosis during Thyrotoxicosis: Case Report and Literature Update
Emanuela Maria Raho, Annibale Antonioni, Niccolò Cotta Ramusino, Dina Jubea, Daniela Gragnaniello, Paola Franceschetti, Francesco Penitenti, Andrea Daniele, Maria Chiara Zatelli, Maurizio Naccarato, Ilaria Traluci, Maura Pugliatti, Marina Padroni
Journal of Personalized Medicine.2023; 13(11): 1557. CrossRef

Original article

Predictive Factors for the Therapeutic Response to Concomitant Treatment with DPP-4 Inhibitors in Type 2 Diabetes with Short-Term Follow-Up: Jong-Ha Baek, Bo Ra Kim, Jeong Woo Hong, Soo Kyoung Kim, Jung Hwa Jung, Jaehoon Jung, Jong Ryeal Hahm; Kosin Med J. 2016;31(2):146-156. Published online January 20, 2016; DOI: https://doi.org/10.7180/kmj.2016.31.2.146

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Abstract PDF PubReader ePub: Abstract Objectives
To evaluate the efficacy and predictive factors of Dipeptidyl peptidase-4 (DPP-4) inhibitors in type 2 diabetes mellitus (T2DM) patients who were not well controlled with other oral antidiabetic drugs or insulin in real clinical practice.
Methods
From December 2012 to January 2014, retrospective longitudinal observation study was conducted for patients with T2DM who were not reached a glycemic target (glycated hemoglobin [HbA1c] > 6.5%) with other oral antidiabetic drugs or insulins. Type 1 diabetes or other types of diabetes were excluded. Responders were eligible with decreased HbA1c from baseline for more than 5% during follow up period.
Results
Of total 135 T2DM patients having an average 9.0 months follow-up period, 84 (62.2%) of patients were responder to DPP-4 inhibitors. After concomitant treatment with DPP-4 inhibitors, patients had a mean decrease in HbA1c of 0.69 ± 1.3%, fasting plasma glucose of 13 ± 52 ㎎/㎗, and postprandial plasma glucose of 29 ± 85 ㎎/㎗ from baseline (all P< 0.05). Independent predictive factor for an improvement of glycemic control with DPP-4 inhibitors was higher baseline HbA1c (odds ratio 2.07 with 95% confidence interval 1.15–3.72) compared with non-responders.
Conclusions
A clinical meaningful improvement in glycemic control was seen when DPP-4 inhibitors were added to other anti-diabetic medications in patients with T2DM regardless of age, duration of T2DM, type of combination treatment regimen. Patients who had higher HbA1c were more easily respond to DPP-4 inhibitors treatment in short-term follow-up period.

Case report

A Case with Empty Sella Syndrome Combined with Multiple Anterior Pituitary Hormone Deficiencies Presenting as Hypoglycemic Coma: Soo Kyoung Kim, Sung Su Kim, Bo Ra Kim, Jung Hwa Jung, Jae Hoon Jung, Jong Ryeal Hahm; Kosin Med J. 2014;29(2):151-155. Published online December 18, 2014; DOI: https://doi.org/10.7180/kmj.2014.29.2.151

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Abstract PDF PubReader: Abstract
A 55-year-old male was admitted to emergency department with a hypoglycemic shock of unknown origin. He was presented with tonic seizure activity after admission. Initial diagnostic procedure could exclude diabetes mellitus, drug side effects, and exogenous insulin application. Detailed evaluation of the patient's history revealed that the patient had experienced repeated hypoglycemic episodes for 2 years. He was diagnosed with hypothyroidism six years ago. Initial laboratory investigations revealed hypoglycemia, hyponatremia, and low plasma cortisol level (0.18 pg/dᄂ)· Sellar magnetic resonance imaging showed empty sella. Replacement therapy with hydrocortisone resulted in the improvement of clinical symptoms. Combined pituitary stimulation test with exception of hypoglycemia induced growth hormone and cortisol stimulation test was performed. The response of thyroid stimulating hormone, prolactin, follicle-stimulating hormone, and luteinizing hormone was normal. We report the case of empty sella syndrome associated with hypoglycemic shock due to with multiple anterior pituitary hormone deficiencies.

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