Subscribe to RSS
DOI: 10.4103/JLP.JLP_53_17
Hypertriglyceridemia-induced acute pancreatitis with diabetic ketoacidosis: A rare presentation of type 1 diabetes mellitus
Abstract
Diabetic ketoacidosis (DKA) is a frequently encountered complication of diabetes mellitus. DKA is an insulin deficit state and results in moderate to severe hypertriglyceridemia (HTG). HTG is the third leading cause of acute pancreatitis (AP) and often goes unnoticed. The triad of DKA, HTG, and AP is rarely seen, and literature on the same is sparse. We report a case of AP which was due to DKA-induced secondary HTG in an adult with previously undiagnosed type 1 diabetes. His HbA1c was significantly raised, and C-peptide level was low, confirming chronic hyperglycemia. He was treated successfully with insulin infusion, intravenous crystalloid, and analgesics.
Publication History
Received: 24 March 2017
Accepted: 05 May 2017
Article published online:
19 February 2020
© 2017.
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
-
References
- 1 Chiasson JL, Aris-Jilwan N, Bélanger R, Bertrand S, Beauregard H, Ekoé JM, et al. Diagnosis and treatment of diabetic ketoacidosis and the hyperglycemic hyperosmolar state. CMAJ 2003;168:859-66.
- 2 Kota S, Jammula S, Kota S, Meher L, Modi K. Acute pancreatitis in association with diabetic ketoacidosis in a newly diagnosed type 1 diabetes mellitus patient; case based review. IJCCI 2012;4:54-60.
- 3 Singla AA, Ting F, Singla A. Acute pancreatitis secondary to diabetic ketoacidosis induced hypertriglyceridemia in a young adult with undiagnosed type 2 diabetes. JOP 2015;16:201-4.
- 4 Yadav D, Nair S, Norkus EP, Pitchumoni CS. Nonspecific hyperamylasemia and hyperlipasemia in diabetic ketoacidosis: Incidence and correlation with biochemical abnormalities. Am J Gastroenterol 2000;95:3123-8.
- 5 Warshaw AL, Bellini CA, Lesser PB. Inhibition of serum and urine amylase activity in pancreatitis with hyperlipemia. Ann Surg 1975;182:72-5.
- 6 Nair S, Yadav D, Pitchumoni CS. Association of diabetic ketoacidosis and acute pancreatitis: Observations in 100 consecutive episodes of DKA. Am J Gastroenterol 2000;95:2795-800.
- 7 Fortson MR, Freedman SN, Webster PD 3rd. Clinical assessment of hyperlipidemic pancreatitis. Am J Gastroenterol 1995;90:2134-9.
- 8 Kota SK, Krishna SV, Lakhtakia S, Modi KD. Metabolic pancreatitis: Etiopathogenesis and management. Indian J Endocrinol Metab 2013;17:799-805.
- 9 Tsuang W, Navaneethan U, Ruiz L, Palascak JB, Gelrud A. Hypertriglyceridemic pancreatitis: Presentation and management. Am J Gastroenterol 2009;104:984-91.
- 10 Dominguez-Muñoz JE, Malfertheiner P, Ditschuneit HH, Blanco-Chavez J, Uhl W, Büchler M, et al. Hyperlipidemia in acute pancreatitis. Relationship with etiology, onset, and severity of the disease. Int J Pancreatol 1991;10:261-7.
- 11 Goldberg IJ. Lipoprotein lipase and lipolysis: Central roles in lipoprotein metabolism and atherogenesis. J Lipid Res 1996;37:693-707.
- 12 Lennertz A, Parhofer KG, Samtleben W, Bosch T. Therapeutic plasma exchange in patients with chylomicronemia syndrome complicated by acute pancreatitis. Ther Apher 1999;3:227-33.