A case of diabetic ketoacidosis induced by chlormadinone acetate

An 84-year-old male was hospitalized on Oct. 13, 1996. On admission lab values were as follows: plasma glucose concentration (928 mg/dl), arterial blood gas analysis (pH 7.201, PaCO₂ 16.2 mmHg, HCO₃ 6.3 mmol/l). All signs indicated severe hyperglycemia with metabolic acidosis. Under a diagnosis of diabetic ketoacidosis (DKA), he was immediately transfused with fluid, insulin and antibiotics. With these treatments, his general condition gradually improved for about 3 days. His past history revealed that chlormadinone acetate (CMA) had been administered for the treatment of prostatic cancer. Our experience with this patient suggested that CMA might have induced DKA, and furthermore that examination of glucose metabolism was prudent in patients under going CMA treatment.