title: Acute Pancreatitis Complicated with Diabetic Ketoacidosis in a Young Adult without Hypertriglyceridemia: A Case Report.
abstract: Systemic complications related to acute pancreatitis include acute respiratory distress syndrome, multiple organ dysfunction syndrome, disseminated intravascular coagulation, hypocalcemia, hyperglycemia, and insulin dependent diabetes or diabetic ketoacidosis. In practice, the development of diabetic ketoacidosis induced by acute pancreatitis is rare and generally associated with hypertriglyceridemia. However, herein we report a case of a 34-year-old female without hypertriglyceridemia, who was diagnosed with acute pancreatitis complicated with diabetic ketoacidosis. The patient was admitted with complaints of febrile sensation, back pain, and abdominal pain around the epigastric area. Levels of serum amylase and lipase were elevated to 663 U/L and 3,232 U/L. Contrast-enhanced abdominal CT showed pancreatic swelling, peri-pancreatic fat infiltration and fluid collection. The patient was initially diagnosed with simple acute pancreatitis. Though the symptoms were rapidly relieved after initiation of treatment, severe hyperglycemia (575 mg/dL), severe metabolic acidosis (pH 6.9), and ketonuria developed at four days after hospitalization. However, serum triglyceride levels remained within the normal range (134 mg/dL). Finally, the patient was diagnosed with acute pancreatitis complicated with diabetic ketoacidosis unrelated to hypertriglyceridemia. She recovered through insulin and fluid therapy, and receives insulin therapy at the outpatient clinic.
authors.affiliation: Department of Internal Medicine, CHA Gumi Medical Center, CHA University School of Medicine, Gumi, Korea.
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, CHA Gumi Medical Center, CHA University School of Medicine, Gumi, Korea.
authors.forename: Myung Jin
authors.initials: MJ
authors.lastname: Oh
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D000208:Acute Disease; D000328:Adult; D000681:Amylases / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D016883:Diabetic Ketoacidosis / Q000150:complications / Q000175:diagnosis*; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D015228:Hypertriglyceridemia / Q000188:drug therapy / Q000209:etiology; D007328:Insulin / Q000627:therapeutic use; D008049:Lipase / Q000097:blood; D010195:Pancreatitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D007328:Insulin; D014280:Triglycerides; D008049:Lipase; D000681:Amylases
keywords: Diabetic ketoacidosis; Hypertriglyceridemia; Pancreatitis