title: Diabetic ketoacidosis presenting with pseudonormoglycemia in a 15-year-old girl with type 1 diabetes mellitus.
abstract: Pseudonormoglycemic diabetic ketoacidosis (DKA) is a rare condition and has been reported only in a few adult patients. We present a 15-year-old girl with a 9-year history of type 1 diabetes who presented with euglycemic and extreme hypertriglyceridemia. The acidosis and hypertriglyceridemia resolved with intravenous insulin therapy and rehydration. Hyperlipidemia was the apparent cause of pseudonormoglycemia in this patient. The findings in the present case demonstrate that also in children, DKA can rarely occur without abnormal blood glucose levels. Assessment of the acid-base status, urinary glucose, and ketone readings is therefore important in all diabetic patients who are unwell at admission and have normal glucose levels. In such patients, hyperlipidemia may cause pseudonormoglycemia. An awareness of this rare treatable life-threatening condition is important.
authors.affiliation: İzmir Tepecik Training and Research Hospital, Department of Pediatric Endocrinology, İzmir, Turkey.
authors.forename: Sinem
authors.initials: S
authors.lastname: Akbay
authors.forename: Arda
authors.initials: A
authors.lastname: Yel
authors.forename: Ülkü
authors.initials: Ü
authors.lastname: Yıldırımer
authors.forename: Şule
authors.initials: Ş
authors.lastname: Can
authors.forename: Bumin
authors.initials: B
authors.lastname: Dündar
mesh_terms: D000293:Adolescent; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications*; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000150:complications*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D015228:Hypertriglyceridemia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin