Shaikh Bilal H, Sohaib Muneebah, Alshantti Raeda, Barrera Francisco, Faridi Farah S, Murvelashvili Natia
Department of Internal Medicine, Presence Saint Francis Hospital, Evanston, IL, USA.
Am J Case Rep. 2018 Nov 10;19:1342-1344. doi: 10.12659/AJCR.911747.
BACKGROUND Severe hypertriglyceridemia is a well-known cause of acute pancreatitis. Mild elevations of triglyceride levels are common in patients presenting with diabetic ketoacidosis (DKA). Rarely, DKA can be accompanied by an elevation of serum triglyceride level severe enough to lead to AP. CASE REPORT We report one such case of a young diabetic male who presented with DKA that was complicated by hypertriglyceridemia-induced acute pancreatitis (HTGAP). We were able to treat the condition with a slightly prolonged infusion of intravenous (IV) regular insulin in an efficient and cost-effective manner with a good outcome. CONCLUSIONS From our experience, DKA-associated HTGAP can be rapidly, efficiently, and cost-effectively treated with IV regular insulin and close biochemical monitoring. A high index of suspicion for acute pancreatitis is necessary in patients with DKA, especially with co-existing hypertriglyceridemia; and all efforts should be made to diagnose it in a timely manner to prevent subsequent complications.
背景 严重高甘油三酯血症是急性胰腺炎的一个众所周知的病因。在患有糖尿病酮症酸中毒（DKA）的患者中，甘油三酯水平轻度升高很常见。DKA很少会伴有血清甘油三酯水平升高到足以导致急性胰腺炎（AP）的程度。病例报告 我们报告了这样一例年轻的糖尿病男性患者，其因DKA就诊，并发了高甘油三酯血症性急性胰腺炎（HTGAP）。我们能够通过稍微延长静脉注射（IV）普通胰岛素的输注时间，以高效且经济有效的方式治疗该病症，并取得了良好的效果。结论 根据我们的经验，DKA相关的HTGAP可以通过静脉注射普通胰岛素和密切的生化监测快速、有效且经济地进行治疗。对于患有DKA的患者，尤其是同时存在高甘油三酯血症的患者，对急性胰腺炎要有高度的怀疑指数；应尽一切努力及时诊断，以预防随后的并发症。
