A case of diabetic ketoacidosis complicated by fatal acute abdominal aortic thrombosis

Hashimoto, Yoshitaka; Itagaki, Yoriko; Sugahara, Sho; Niimi, Mikiko; Nakazawa, Jun; Takaya, Kiho; Ishii, Michiyo; Kamiuchi, Kenji; Isono, Motohide

doi:10.1007/s13340-013-0115-1

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…found that four out of 17 patients with HHS admitted to the intensive care unit had the complication of limb ischemia. There are also scattered case reports of acute arterial occlusive diseases complicated by DKA 22,23 ; however, some of the reported cases were MIX in our classification 24–26 . MIX might be the strongest risk factor for acute arterial occlusive diseases among all hyperglycemic crises, and, thus, further large‐scale studies are warranted.…”

Section: Discussionmentioning

confidence: 73%

Clinical profiles of hyperglycemic crises: A single‐center retrospective study from Japan

Nishikawa

Kinoshita

Ono

et al. 2021

J of Diabetes Invest

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Aims/Introduction The aim of the present study was to clarify the pathophysiologies of hyperglycemic crises in Japanese patients. Materials and Methods This was a retrospective study of patients with hyperglycemic crises admitted to Kumamoto Medical Center, Kumamoto, Japan, between 2012 and 2019. Patients were classified as having diabetic ketoacidosis (DKA), hyperglycemic hyperosmotic syndrome (HHS) or a mixed state of the two conditions (MIX), and laboratory data and levels of consciousness at hospital admission, as well as the rates of mortality and coagulation disorders, were compared. Results The diagnostic criteria for hyperglycemic crisis were met in 144 cases, comprising 87 (60.4%), 38 (26.4%) and 19 (13.2%) cases of DKA, HHS and MIX, respectively. Type 1 diabetes was noted in 46.0 and 26.3% of patients in the DKA and MIX groups, respectively. Fibrin degradation product and D‐dimer levels were significantly higher in the HHS group than in the DKA group (DKA and HHS groups: fibrin degradation product 7.94 ± 8.43 and 35.54 ± 51.80 μg/mL, respectively, P < 0.01; D‐dimer 2.830 ± 2.745 and 14.846 ± 21.430 μg/mL, respectively, P < 0.01). Mortality rates were 5.7, 13.2 and 5.3% in the DKA, HHS and MIX groups, respectively. Seven patients (4.9%), four of whom were in the MIX group, had acute arterial occlusive diseases. Conclusions The low frequency of type 1 diabetes in DKA and MIX might be responsible for reduced insulin secretion in Japanese populations. Patients with hyperglycemic crises have increased coagulability, and acute arterial occlusion needs to be considered, particularly in MIX.

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Section: Discussionmentioning

confidence: 73%

Clinical profiles of hyperglycemic crises: A single‐center retrospective study from Japan

Nishikawa

Kinoshita

Ono

et al. 2021

J of Diabetes Invest

View full text Add to dashboard Cite

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“…Diabetic ketoacidosis (DKA), which is one of the most serious acute complications of diabetes, can occur in conjunction with acute major illnesses, such as sepsis, pancreatitis, and thrombosis (1)(2)(3). In cases of DKA, clinicians should therefore be vigilant in addressing both DKA management and the complicating illness.…”

Section: Introductionmentioning

confidence: 99%

Superior Mesenteric Artery Syndrome Complicated by Diabetic Ketoacidosis and Graves' Disease in Slowly Progressive Insulin Dependent Diabetes Mellitus (SPIDDM): A Case Report and a Review of the Literature

et al. 2016

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A 48-year-old woman with a history of diabetes was admitted for nausea and vomiting with body weight loss. A blood examination revealed high plasma glucose and thyroid hormone levels and metabolic acidosis. She was therefore diagnosed with both diabetic ketoacidosis (DKA) and hyperthyroidism. Nausea and vomiting continued intermittently despite the administration of saline and insulin. The patient was further diagnosed with superior mesenteric artery syndrome (SMAS) after abdominal computed tomography revealed that a horizontal portion of the duodenum was sandwiched between the aorta and the superior mesenteric artery. Clinicians should be vigilant for SMAS in patients with both DKA and hyperthyroidism who present body weight loss.

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A case of diabetic ketoacidosis complicated by fatal acute abdominal aortic thrombosis

Cited by 2 publications

References 11 publications

Clinical profiles of hyperglycemic crises: A single‐center retrospective study from Japan

Clinical profiles of hyperglycemic crises: A single‐center retrospective study from Japan

Superior Mesenteric Artery Syndrome Complicated by Diabetic Ketoacidosis and Graves' Disease in Slowly Progressive Insulin Dependent Diabetes Mellitus (SPIDDM): A Case Report and a Review of the Literature

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