10 July 2024
: Case report 
Euglycemic Ketoacidosis in a Patient without Diabetes Taking Sodium-Glucose Cotransporter 2 Inhibitors for Heart Failure
Rare coexistence of disease or pathology
Masamune Miyazaki1ABCDEFG*, Masanobu Nakano1D, Hisako Takahashi1D, Yoshihiro Isaka1D, Yoshikazu Hiura1AEDOI: 10.12659/AJCR.943945
Am J Case Rep 2024; 25:e943945
Table 1. The patient’s laboratory test results.
| Parameter | Result | Reference range |
|---|---|---|
| pH | 7.329 | 7.35–7.45 |
| pCO (mmHg) | 28.1 | 35.0–45.0 |
| pO (mmHg) | 97.6 | 80–100 |
| HCO (mmol/L) | 14.3 | 23–29 |
| Anion gap (mmol/L) | 20.7 | 10.0–14.0 |
| Lactate (mg/dL) | 11 | 4.5–14.4 |
| Plasma glucose (mg/dL) | 124 | 73–109 |
| Hemoglobin A1c (%) | 5.9 | 4.6–6.2 |
| Plasma insulin (µU/mL) | 14.7 | 2.7–18.7 |
| C-peptide (ng/mL) | 3.75 | 0.8–2.5 |
| Total ketone bodies (µmol/L) | 6500 | 0–131 |
| Acetoacetate (µmol/L) | 1350 | 0–55 |
| β-hydroxybutyrate (µmol/L) | 5150 | 0–85 |
| White blood cells (×10/µL) | 9.03 | 3.17–8.40 |
| Red blood cells (×10/µL) | 4.48 | 3.72–5.06 |
| Hemoglobin (mg/dL) | 13.2 | 11.0–14.7 |
| Na (mEq/L) | 133 | 138–145 |
| K (mEq/L) | 4.8 | 3.6–4.8 |
| Cl (mEq/L) | 98 | 101–108 |
| IP (mEq/L) | 3.2 | 2.5–4.5 |
| BUN (mg/dL) | 24.4 | 8.0–20.0 |
| Creatinine (mg/dL) | 0.72 | 0.40–0.80 |
| NT-proBNP (pg/mL) | 2376 | ≤125 |
| C-reactive protein (mg/dL) | 0.66 | ≤0.26 |
| Ketones | 3+ | (−) |
| Glucose | 4+ | (−) |
| Protein | (−) | (−) |
| BUN – blood urea nitrogen; IP – inorganic phosphorus; NT-proBNP – N-terminal pro B-type natriuretic peptide; pCO – partial pressure of carbon dioxide; pO – partial pressure of oxygen. | ||