暴发性1型糖尿病所致糖尿病酮症酸中毒：1型糖尿病的一种罕见亚型，可导致异常后遗症。
Diabetic ketoacidosis due to fulminant type 1 diabetes: A rare subtype of type 1 diabetes leading to unusual sequelae.
作者信息
Lane Andrew S, Champion Bernard, Orde Sam, Dravec Danijela
机构信息
Sydney Medical School, Sydney, NSW, Australia.
Nepean Hospital, Sydney, NSW, Australia.
出版信息
J Intensive Care Soc. 2015 Feb;16(1):64-70. doi: 10.1177/1751143714551249. Epub 2014 Dec 10.
Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes (T1D), which without treatment leads to death. Fulminant type 1 diabetes (FT1D) is a subtype characterised by a markedly rapid and almost complete destruction of pancreatic β-cells, with acute onset leading to severe metabolic derangement and commonly ICU admission. We present a case of an 18-year-old male presenting with FT1D with two rare complications of pneumomediastinum and stress-induced cardiomyopathy (SIC) with significant myocardial necrosis. We also discuss the aetiology of the pneumomediastinum; the latest thoughts on SIC: moving beyond the simple description of 'Takotsubo cardiomyopathy'; the role of troponins in critical illness; and genetic predisposition for DKA due to FT1D.
糖尿病酮症酸中毒（DKA）是1型糖尿病（T1D）的一种危及生命的并发症，如不治疗会导致死亡。暴发性1型糖尿病（FT1D）是一种亚型，其特征是胰腺β细胞明显快速且几乎完全被破坏，急性起病导致严重的代谢紊乱，患者通常需入住重症监护病房（ICU）。我们报告一例18岁男性患者，患有FT1D，并伴有纵隔气肿和应激性心肌病（SIC）这两种罕见并发症，且存在明显的心肌坏死。我们还讨论了纵隔气肿的病因；关于SIC的最新观点：超越对“应激性心肌病”的简单描述；肌钙蛋白在危重病中的作用；以及FT1D所致DKA的遗传易感性。
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