혈액검사에서 정상이었으나 당뇨망막병증과 당뇨신병증 소견을 보여 당뇨로 진단된 1예
A Case of Diabetes Mallitus Following Diabetic Retinopathy and Nephropathy with Normal Blood Test
- 대한검안학회
- Annals of optometry and contact lens
- Vol.17 No.1
- 2018.03
- 14 - 17 (4 pages)
Purpose: To report a case of diabetic mellitus following diabetic retinopathy and diabetic nephropathy in a patient with no history of previous diabetes mellitus and no evidence of diabetes in the blood test. Case summary: A 39-year-old man with no previous history of diabetes mellitus was referred to our clinic for further diagnosis because of suspected diabetic nephropathy. No specific findings on the anterior segment were found on slit lamp microscopy. Fundus examination revealed flame-shaped retinal hemorrhages and cotton wool spots around optic disc and macula in both eyes. No other specific findings were observed. Urine glucose was not detected in the urine test at admission and glucose was normal in the blood test. The hemoglobin A1c (HbA1c) test was normal in 5.8. Diabetic retinopathy was diagnosed by fundus examination, and diabetes was confirmed by oral glucose tolerance test (OGTT test). Conclusions: Although the patient was not aware of the presence of diabetes, diabetic retinopathy was often diagnosed by fundus examination. In this case, diabetic retinopathy was diagnosed by fundus examination after suspicion of diabetes through renal biopsy in the absence of diagnosis of diabetes in internal medicine. After all, diabetes could be diagnosed in internal medicine conversely. It can be reemphasized once again how important it is to perform fundus examination early in diagnosing diabetic patients.
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