Challenging differential diagnosis, Unusual or unexpected effect of treatment, Rare disease
Bilal H. Shaikh, Muneebah Sohaib, Raeda Alshantti, Francisco Barrera, Farah S. Faridi, Natia Murvelashvili
(Department of Internal Medicine, Presence Saint Francis Hospital, Evanston, IL, USA)
Am J Case Rep 2018; 19:1342-1344
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, Pancreatitis