Marfan syndrome with type 2 diabetes mellitus: A case report from China

Medicine (Baltimore). 2019 Jan;98(3):e14176. doi: 10.1097/MD.0000000000014176.

Abstract

Rationale: Marfan syndrome (MFS) is a genetic disorder of the connective tissue. MFS has an incidence of about 2 to 3 persons per 10,000 population. MFS is characterized majorly by the involvement of the eyes, skeletal muscles, and cardiovascular system. There are limited case reports of co-existence of MFS and type 2 diabetes mellitus (T2DM).

Patient concerns: A 16-year-old male patient who got admitted to our hospital with complaints of loss of vision from left eye for the last 3 days.Diagnosis of MFS along with luxation of left eye lens, and T2DM were made according to the patient's symptoms, signs, biochemical results, and ultrasonography.

Interventions: The patient received "vitrectomy (posterior approach (left eye)) + cataract extraction (left eye) + intraocular lens implantation (left eye) surgery" for luxation of left eye lens. The patient received "Bentall Operation" for MFS, and was prescribed warfarin 5 mg qod and spironolactone 20 mg bid during the follow-up period. The patient received continuous subcutaneous insulin infusion (CSII) during hospitalization, and then changed to insulin glargine preparation during the follow-up period.

Outcomes: The vision was restored after the eye surgery and the patient also recovered well after the Bentall Operation. Additionally, there were no obvious complications during hospitalization and the follow-up period. Blood glucose levels were within normal range.

Lessons: There is a need to improve the recognition of MFS among school and community doctors. Early detection, diagnosis, and treatment of this rare disease can improve the quality of patient's life.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Cataract / complications
  • Cataract Extraction / methods
  • China
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / therapy
  • Humans
  • Insulin / therapeutic use
  • Lens Implantation, Intraocular / methods
  • Lens Subluxation / complications
  • Lens Subluxation / surgery
  • Male
  • Marfan Syndrome / complications*
  • Marfan Syndrome / diagnosis
  • Marfan Syndrome / therapy
  • Vitrectomy / methods

Substances

  • Insulin