Renal Cell Carcinoma–Associated Diabetes Mellitus Due to Paraneoplastic Syndrome in Maintenance Hemodialysis: A Case Report
A 59-year-old Japanese woman with a 22-year history of long-term hemodialysis was admitted to our hospital for further examination of hyperglycemia and anemia. Five months before hospitalization, her fasting plasma glucose value was 99 mg/dL and her glycated hemoglobin was 5.7%. On admission, her fa...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-06-01
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| Series: | Kidney Medicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590059522000917 |
| _version_ | 1818546937567117312 |
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| author | Yusuke Yoshimura Tatsuya Suwabe Daisuke Ikuma Yuki Oba Masayuki Yamanouchi Akinari Sekine Hiroki Mizuno Eiko Hasegawa Junichi Hoshino Kei Kono Keiichi Kinowaki Kenichi Ohashi Naoki Sawa Yoshifumi Ubara |
| author_facet | Yusuke Yoshimura Tatsuya Suwabe Daisuke Ikuma Yuki Oba Masayuki Yamanouchi Akinari Sekine Hiroki Mizuno Eiko Hasegawa Junichi Hoshino Kei Kono Keiichi Kinowaki Kenichi Ohashi Naoki Sawa Yoshifumi Ubara |
| author_sort | Yusuke Yoshimura |
| collection | DOAJ |
| description | A 59-year-old Japanese woman with a 22-year history of long-term hemodialysis was admitted to our hospital for further examination of hyperglycemia and anemia. Five months before hospitalization, her fasting plasma glucose value was 99 mg/dL and her glycated hemoglobin was 5.7%. On admission, her fasting plasma glucose value was 873 mg/dL, glycated hemoglobin was 16.2%, C-peptide reactivity was 22.3 ng/mL (reference range, 0.5-3.0), and homeostasis model assessment of insulin resistance (HOMA-IR) was 10.6 (reference range, <2.0); the high HOMA-IR indicated high insulin resistance. Intensive insulin therapy was started for hyperglycemia, which required more than 40 units/day. Computed tomography showed a hypervascular lesion 2.2 cm in diameter on the right kidney; therefore, right nephrectomy was performed. Complete resection was confirmed, and the lesion was diagnosed as a clear cell type of renal cell carcinoma (RCC). Immediately after nephrectomy, glycemic control normalized and administration of insulin was discontinued. Fourteen days after nephrectomy, the HOMA-IR decreased to 2.96. RCC that develops in patients receiving long-term hemodialysis has been reported to be dialysis-related RCC, but there have been no reports suggesting a relationship between dialysis-related RCC and diabetes. To our knowledge, this is the first report of RCC presenting with the paraneoplastic syndrome of acute-onset diabetes because of insulin resistance. |
| first_indexed | 2024-12-12T07:59:54Z |
| format | Article |
| id | doaj.art-067755d8feb444ed96fa57e09ae397c8 |
| institution | Directory Open Access Journal |
| issn | 2590-0595 |
| language | English |
| last_indexed | 2024-12-12T07:59:54Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney Medicine |
| spelling | doaj.art-067755d8feb444ed96fa57e09ae397c82022-12-22T00:32:11ZengElsevierKidney Medicine2590-05952022-06-0146100477Renal Cell Carcinoma–Associated Diabetes Mellitus Due to Paraneoplastic Syndrome in Maintenance Hemodialysis: A Case ReportYusuke Yoshimura0Tatsuya Suwabe1Daisuke Ikuma2Yuki Oba3Masayuki Yamanouchi4Akinari Sekine5Hiroki Mizuno6Eiko Hasegawa7Junichi Hoshino8Kei Kono9Keiichi Kinowaki10Kenichi Ohashi11Naoki Sawa12Yoshifumi Ubara13Nephrology Center, Toranomon Hospital Kajigaya, Kanagawa, Japan; Address for Correspondence: Yusuke Yoshimura, MD, Nephrology Center, Toranomon Hospital Kajigaya, 1-3-1, Kajigaya, Takatsu, Kawasaki, Kanagawa, 213-8587, Japan.Nephrology Center, Toranomon Hospital Kajigaya, Kanagawa, Japan; Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, JapanNephrology Center, Toranomon Hospital Kajigaya, Kanagawa, JapanNephrology Center, Toranomon Hospital Kajigaya, Kanagawa, JapanNephrology Center, Toranomon Hospital Kajigaya, Kanagawa, JapanNephrology Center, Toranomon Hospital Kajigaya, Kanagawa, JapanNephrology Center, Toranomon Hospital Kajigaya, Kanagawa, JapanNephrology Center, Toranomon Hospital Kajigaya, Kanagawa, JapanNephrology Center, Toranomon Hospital Kajigaya, Kanagawa, Japan; Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, JapanDepartment of Pathology, Toranomon Hospital, Tokyo, JapanDepartment of Pathology, Toranomon Hospital, Tokyo, JapanDepartment of Pathology, Toranomon Hospital, Tokyo, Japan; Department of Human Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, JapanNephrology Center, Toranomon Hospital Kajigaya, Kanagawa, Japan; Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, JapanNephrology Center, Toranomon Hospital Kajigaya, Kanagawa, Japan; Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, JapanA 59-year-old Japanese woman with a 22-year history of long-term hemodialysis was admitted to our hospital for further examination of hyperglycemia and anemia. Five months before hospitalization, her fasting plasma glucose value was 99 mg/dL and her glycated hemoglobin was 5.7%. On admission, her fasting plasma glucose value was 873 mg/dL, glycated hemoglobin was 16.2%, C-peptide reactivity was 22.3 ng/mL (reference range, 0.5-3.0), and homeostasis model assessment of insulin resistance (HOMA-IR) was 10.6 (reference range, <2.0); the high HOMA-IR indicated high insulin resistance. Intensive insulin therapy was started for hyperglycemia, which required more than 40 units/day. Computed tomography showed a hypervascular lesion 2.2 cm in diameter on the right kidney; therefore, right nephrectomy was performed. Complete resection was confirmed, and the lesion was diagnosed as a clear cell type of renal cell carcinoma (RCC). Immediately after nephrectomy, glycemic control normalized and administration of insulin was discontinued. Fourteen days after nephrectomy, the HOMA-IR decreased to 2.96. RCC that develops in patients receiving long-term hemodialysis has been reported to be dialysis-related RCC, but there have been no reports suggesting a relationship between dialysis-related RCC and diabetes. To our knowledge, this is the first report of RCC presenting with the paraneoplastic syndrome of acute-onset diabetes because of insulin resistance.http://www.sciencedirect.com/science/article/pii/S2590059522000917Acute-onset diabetesinsulin resistancehomeostasis model assessment of insulin resistanceparaneoplastic syndromesrenal cell carcinoma |
| spellingShingle | Yusuke Yoshimura Tatsuya Suwabe Daisuke Ikuma Yuki Oba Masayuki Yamanouchi Akinari Sekine Hiroki Mizuno Eiko Hasegawa Junichi Hoshino Kei Kono Keiichi Kinowaki Kenichi Ohashi Naoki Sawa Yoshifumi Ubara Renal Cell Carcinoma–Associated Diabetes Mellitus Due to Paraneoplastic Syndrome in Maintenance Hemodialysis: A Case Report Kidney Medicine Acute-onset diabetes insulin resistance homeostasis model assessment of insulin resistance paraneoplastic syndromes renal cell carcinoma |
| title | Renal Cell Carcinoma–Associated Diabetes Mellitus Due to Paraneoplastic Syndrome in Maintenance Hemodialysis: A Case Report |
| title_full | Renal Cell Carcinoma–Associated Diabetes Mellitus Due to Paraneoplastic Syndrome in Maintenance Hemodialysis: A Case Report |
| title_fullStr | Renal Cell Carcinoma–Associated Diabetes Mellitus Due to Paraneoplastic Syndrome in Maintenance Hemodialysis: A Case Report |
| title_full_unstemmed | Renal Cell Carcinoma–Associated Diabetes Mellitus Due to Paraneoplastic Syndrome in Maintenance Hemodialysis: A Case Report |
| title_short | Renal Cell Carcinoma–Associated Diabetes Mellitus Due to Paraneoplastic Syndrome in Maintenance Hemodialysis: A Case Report |
| title_sort | renal cell carcinoma associated diabetes mellitus due to paraneoplastic syndrome in maintenance hemodialysis a case report |
| topic | Acute-onset diabetes insulin resistance homeostasis model assessment of insulin resistance paraneoplastic syndromes renal cell carcinoma |
| url | http://www.sciencedirect.com/science/article/pii/S2590059522000917 |
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