title: Fulminant type 1 diabetes complicated by leukemoid reaction.
abstract: A 28-year-old woman with severe ketoacidosis was admitted to our hospital on day 11 after giving birth. However, her HbA(1C) level was normal (5.2%) and both GAD and anti-insulin autoantibody were negative, and the WBC count was extremely high (57,500/ml) with immature leucocytes in the peripheral blood. Her WBC count decreased along with control of ketoacidosis and reduction of the plasma glucose level, and was normalized on day 5 after admission. Bone marrow aspiration subsequently showed no malignant cells, so the final diagnosis was fulminant type 1 diabetes combined with a leukemoid reaction. This is the first report of a patient with both fulminant type 1 diabetes and a leukemoid reaction. The mechanism that triggered the leukemoid reaction could not be clarified, but severe ketoacidosis may have been involved.
authors.affiliation: Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki.
authors.forename: Naoko
authors.initials: N
authors.lastname: Obi
authors.forename: Takuyuki
authors.initials: T
authors.lastname: Katabami
authors.forename: Shiko
authors.initials: S
authors.lastname: Asai
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Saito
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Tanaka
mesh_terms: D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D016883:Diabetic Ketoacidosis / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy / Q000503:physiopathology; D007955:Leukemoid Reaction / Q000150:complications*; D049590:Postpartum Period / Q000502:physiology