Diabetes Mellitus secundária, a ponta do iceberg: a propósito de dois casos clínicos
Palavras-chave:
Diabetes Mellitus secundária, Acromegalia, Síndroma de Cushing, Carcinoma da suprarrenalResumo
Descrevemos dois casos clínicos raros de Diabetes Mellitus (DM)
secundária, cuja avaliação etiológica revelou um macroadenoma hipofisário secretor de GH e um tumor secretor de cortisol,
localizado unilateralmente na cortical da suprarrenal. Ambos os
casos têm a particularidade de terem sido internados pelo Serviço
de Urgência com quadros agudos associados à diabetes, antes
de serem conhecidas as patologias endócrinas subjacentes. O
primeiro (Acromegalia) foi internado por hiperglicemia grave e
hiperosmolalidade. O segundo foi internado por hipoglicemia
iatrogénica e tratava-se de um carcinoma, forma rara de manifestação da Síndroma de Cushing.
Tecemos algumas considerações teóricas sobre a fisiopatologia
da hiperglicémia secundária a estas doenças. Referimos alguns
conhecimentos actuais sobre a epidemiologia, o diagnóstico, o
tratamento e o prognóstico de ambas as endocrinopatias.
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Referências
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