A 58-year-old man complained of polyuria, polydipsia, weight loss 1 week before admission. He had anemia and splenomegaly, skin of grey and hepatomegaly. Oral glucose tolerance test showed a diagnosis of diabetes mellitus, insulin release test showed a decreased pancreatic islet function. Serum iron and ferritin were elevated. The pathology of liver tissue showed diffuse distribution of hemosiderin granules with positive Prussian blue staining. Insulin therapy and iron chelation therapy were effective. Diabetes mellitus is present in approximately half of patients at the time of hemochromatosis diagnosis. The excess iron involved in oxidative stress and the formation of lipid peroxides, resulting in pancreatic islet beta cell failure and diabetes.%本文报道1例以糖尿病就诊的继发性血色病(SHC)病例.患者男,58岁,因“多尿、多饮、体重下降1周”人院.既往有贫血、脾大史.查体发现皮肤青灰色、肝大.糖耐量试验确诊糖尿病,胰岛素释放试验提示曲线低平,胰岛功能差.血清铁及铁蛋白升高.肝组织病理提示弥漫分布含铁血黄素颗粒,普鲁士蓝染色阳性.胰岛素治疗及铁螯合剂治疗有效.近一半患者在发现血色病时已发生糖尿病.过量的铁参与氧化应激,形成脂质过氧化物,造成胰岛β细胞衰竭,导致糖尿病.
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