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 HbA1C level was normal (5.2%) and both GAD and anti-insulin autoantibody were negative, and the WBC count was extremely high (57,500/ml)

The fulminant index: A method of rapidly differentiating fulminant type 1 diabetes from diabetic ketoacidosis

“…As universally agreed, as DKA arising, the priority is correcting ketoacidosis, while detecting the cause of DKA come to the back of the pipeline. Nevertheless, FT1D patients are highly susceptible to various lethal complications including the increase in pancreatic enzymes, 6 increase of muscle enzymes and even rhabdomyolysis, 7 leukaemia‐like reaction, 8 sudden death, or cardiac arrest 9 . In that way, it could be necessary for clinicians to recognise FT1D early when handling DKA cases to identify highly risky cases and conduct the timely intervention.…”

The Fulminant Index: A Method of Rapidly Differentiating Fulminant Type 1 Diabetes From Diabetic Ketoacidosis

“…As universally agreed, as DKA arise, for the clinicians, the rst priority is correcting ketoacidosis, while detecting the cause of DKA and determination of the diagnosis come to back of the pipeline. Nevertheless, since FT1D-DKA patients are highly susceptible to various lethal complications including increase in pancreatic enzymes 6 , increase of muscle enzymes and even rhabdomyolysis 7 , leukemia-like reaction 8 , sudden death, or cardiac arrest 9 , it could be necessary for clinicians to recognize FT1D early when handling DKA cases, which could help identify highly risky cases and conduct timely intervention. Besides, a fraction of FT1D cases caused by medication 10 or pregnancy 11 also rely on early recognition to receive appropriate treatment.…”