Acute Pancreatitis Secondary to Diabetic Ketoacidosis Induced Hypertriglyceridemia in a Young Adult with Undiagnosed Type 2 Diabetes

摘要

Context The triad of acutepancreatitis, hypertriglyceridemia and diabetes is a rare occurrence. Casereport A previously well 19-year-old male presented to the emergencydepartment with 24-hour history of epigastric pain, associated with polyuriaand nausea. Biochemical markers showed the presence of hyperglycemia (bloodsugar level 15 mmol/L) and ketonemia (5.3 mmol/L). Further investigationrevealed severe hypertriglyceridemia (4,009 mg/dL) and elevated lipase (1,714U/L). Abdominal ultrasound confirmed the diagnosis of acute pancreatitis. Hewas transferred to intensive care, where he received i.v. hydration, insulinand dextrose infusion. His metabolic derangements gradually resolved. Hisglycosylated hemoglobin was 13%, indicating the presence of chronicallyelevated blood sugars. Conclusion The possible pathophysiology andmanagement of this unusual triad: diabetic ketoacidosis, hypertriglyceridemiaand acute pancreatitis, are explored in this paper.