title: Anaphylaxis-induced diabetic ketoacidosis.
abstract: Allergic reactions and complications of diabetes mellitus are commonly seen in emergency departments and primary care settings. Although stress is a known contributor to the development of diabetic ketoacidosis (DKA), anaphylaxis-induced DKA has not previously been described. The case of a type 1 diabetic woman who presented with anaphylaxis secondary to seafood ingestion and subsequently developed DKA is reported. It was concluded that stress and counter-regulatory hormones released during anaphylaxis, as well as the treatment with epinephrine and glucocorticoids, precipitated DKA in this patient despite ongoing insulin and fluid therapy. Type 1 diabetic patients experiencing anaphylaxis may require prolonged periods of observation and measurement of serial blood glucose and urine ketones.
authors.affiliation: Department of Emergency Medicine, East Carolina University School of Medicine, Greenville, NC 27850.
authors.forename: G
authors.initials: G
authors.lastname: Greenbaum
authors.forename: J D
authors.initials: JD
authors.lastname: Riley
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000150:complications* / Q000188:drug therapy / Q000209:etiology; D001786:Blood Glucose; D002245:Carbon Dioxide / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D016883:Diabetic Ketoacidosis / Q000209:etiology* / Q000503:physiopathology; D004630:Emergencies; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D010349:Patient Compliance; D017747:Seafood / Q000009:adverse effects*
chemical_list: D001786:Blood Glucose; D002245:Carbon Dioxide; D004837:Epinephrine