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10 November 2018 : Case report  USA

Diabetic Ketoacidosis and the Domino Effect

Challenging differential diagnosis, Unusual or unexpected effect of treatment, Rare disease

Bilal H. Shaikh1ABEF*, Muneebah Sohaib1DEF, Raeda Alshantti1EF, Francisco Barrera1DE, Farah S. Faridi1F, Natia Murvelashvili1EF

DOI: 10.12659/AJCR.911747

Am J Case Rep 2018; 19:1342-1344

Abstract

BACKGROUND: Severe hypertriglyceridemia is a well-known cause of acute pancreatitis. Mild elevations of triglyceride levels are common in patients presenting with diabetic ketoacidosis (DKA). Rarely, DKA can be accompanied by an elevation of serum triglyceride level severe enough to lead to AP.

CASE REPORT: We report one such case of a young diabetic male who presented with DKA that was complicated by hypertriglyceridemia-induced acute pancreatitis (HTGAP). We were able to treat the condition with a slightly prolonged infusion of intravenous (IV) regular insulin in an efficient and cost-effective manner with a good outcome.

CONCLUSIONS: From our experience, DKA-associated HTGAP can be rapidly, efficiently, and cost-effectively treated with IV regular insulin and close biochemical monitoring. A high index of suspicion for acute pancreatitis is necessary in patients with DKA, especially with co-existing hypertriglyceridemia; and all efforts should be made to diagnose it in a timely manner to prevent subsequent complications.

Keywords: Diabetic Ketoacidosis, Hypertriglyceridemia

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923