Title

Hypoglycemia-induced neurogenic-type pulmonary edema: an underrecognized association.

Publication/Presentation Date

9-1-2004

Abstract

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.

Volume

10

Issue

5

First Page

429

Last Page

431

ISSN

1530-891X

Disciplines

Medicine and Health Sciences

PubMedID

15760791

Department(s)

Department of Medicine

Document Type

Article

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