title: A case of diabetic ketoacidosis associated with Guillain-Barré syndrome.
abstract: A 64-year-old woman was referred to our center presenting with thirst, malaise, and pain in both legs which occurred one week before admission. She was revealed to have hyperglycemia and diabetic ketoacidosis (DKA). After therapy for diabetic ketoacidosis was started, her blood glucose levels were improved, but urinary ketone body excretion persisted. Laboratory examination indicated a significant impairment of insulin secretion, although anti-GAD and anti-IA-2 antibody were not detected. After admission, she complained about weakness of lower extremities, which spread to her upper extremities. The diagnosis of Guillain-Barré syndrome (GBS) was made based on the nerve conduction study and cerebrospinal fluid analysis. The intravenous immunoglobulin therapy was started, and her muscle weakness showed gradual improvement. Although the possibility that GBS was casually accompanied with DKA could not be completely excluded, we considered that DKA triggered the development of GBS in this case. Although GBS is a rare condition, the present case suggests that GBS should be included in the differential diagnosis of DKA with its atypical course.
authors.affiliation: Center for Diabetes and Endocrinology, Tazuke Kofukai Medical Research Institute Kitano Hospital, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kanemasa
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Hamamoto
authors.forename: Yorihiro
authors.initials: Y
authors.lastname: Iwasaki
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Kawasaki
authors.forename: Sachiko
authors.initials: S
authors.lastname: Honjo
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ikeda
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Wada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Koshiyama
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D016883:Diabetic Ketoacidosis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D005260:Female; D020275:Guillain-Barre Syndrome / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007328:Insulin / Q000378:metabolism / Q000627:therapeutic use; D000078790:Insulin Secretion; D008875:Middle Aged; D009431:Neural Conduction
chemical_list: D016756:Immunoglobulins, Intravenous; D007328:Insulin