Hypoglycemia-induced neurogenic-type pulmonary edema: an underrecognized association.
OBJECTIVE: To report a case of hypoglycemia-induced pulmonary edema and to analyze the underlying pathophysiologic processes.
METHODS: A case report with clinical and laboratory data is presented, and related studies from the medical literature are discussed.
RESULTS: A 23-year-old man with type 1 diabetes was brought to the emergency department because he was found unconscious at home. Despite a morning blood glucose level of 30 mg/dL, he had taken his usual dose of Lente insulin (40 U), and a period of unconsciousness of unknown duration ensued. Intravenous administration of dextrose increased his blood glucose level to 118 mg/dL, but x-ray films of the chest disclosed evidence of pulmonary edema. After 48 hours of supportive care, his respiratory signs and symptoms resolved. The pathophysiologic construct for hypoglycemia-induced pulmonary edema is thought to be the same as for neurogenic pulmonary edema, with a massive sympathetic nervous system discharge being the common denominator in both conditions.
CONCLUSION: Clinicians should be aware that severe hypoglycemia can lead to noncardiogenic pulmonary edema as a result of a massive sympathetic nervous system discharge and its associated hemodynamic alterations, in the same manner as occurs in neurogenic pulmonary edema.
Published In/Presented At
Mishriki Y. Y. (2004). Hypoglycemia-induced neurogenic-type pulmonary edema: an underrecognized association. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 10(5), 429–431. https://doi.org/10.4158/EP.10.5.429
Medicine and Health Sciences
Department of Medicine