Korean J Med.  2010 Nov;79(5):573-576.

A case of hyperosmolar nonketotic coma associated with androgen deprivation therapy in prostate cancer

• Hong EY
• Lee SW
• Kang JG
• Kim CS
• Ihm SH
• Yoo HJ
• Lee SJ

Abstract

During advanced prostate cancer, androgen deprivation therapy (ADT) using gonadotropin-releasing hormone and antiandrogen is an effective treatment modality. Recently, it has been reported that ADT may result in diabetes mellitus (DM), metabolic syndrome, and cardiovascular disease. Here, we report the first case in the literature of new-onset DM and hyperosmolar nonketotic coma (HNKC) associated with ADT. A 69-year-old man visited our hospital because of altered mentality. The patient had been taking leuprolide and bicalutamide for metastatic prostate cancer for the past 4 months. In laboratory tests, new-onset DM with HNKC was diagnosed. The patient was immediately treated with intravenous hydration and insulin therapy, and recovered without sequela. Because ADT can cause DM, or rarely HNKC, it is necessary to monitor fasting blood glucose and lipid profiles carefully while ADT is performed.

Keyword

Androgen antagonist; Diabetes mellitus; Hyperosmolar nonketotic coma; Prostate cancer

MeSH Terms

Aged
Anilides
Blood Glucose
Cardiovascular Diseases
Coma
Diabetes Mellitus
Fasting
Gonadotropin-Releasing Hormone
Humans
Insulin
Leuprolide
Nitriles
Organothiophosphorus Compounds
Prostate
Prostatic Neoplasms
Tosyl Compounds
Anilides
Blood Glucose
Gonadotropin-Releasing Hormone
Insulin
Leuprolide
Nitriles
Organothiophosphorus Compounds
Tosyl Compounds