Zaher Fatima Zahra, Boubagura Imane, Rafi Sana, Elmghari Ghizlane, Elansari Nawal
Department of Endocrinology, Diabetes, Metabolic Diseases and Nutrition, Mohammed VI University Hospital, Marrakech, Morocco.
Case Rep Endocrinol. 2019 Jan 6;2019:8974619. doi: 10.1155/2019/8974619. eCollection 2019.
Diabetic ketoacidosis (DKA) is a life-threatening acute metabolic complication occurring in patients with diabetes, especially in patients with type 1 diabetes (T1D), due to an insulin deficiency. Moderate hypertriglyceridemia is commonly observed in DKA but severe hypertriglyceridemia with a triglyceride level exceeding 10g/L is very rarely reported. We report a case of a 14-year-old boy who had type 1 diabetes for 4 years treated with insulin therapy, also having adrenal insufficiency treated with hydrocortisone who presented with ketoacidosis and excruciating abdominal pain. Investigations revealed hypertriglyceridemia at 64g/L, lipasemia at 1000 U/L, and stage E pancreatitis on abdominal CT. The patient was treated with intravenous insulin, rehydration, and fenofibrate with good clinical and biological evolution. Severe hypertriglyceridemia causing pancreatitis in type 1 diabetes mellitus is a rare but very serious complication of DKA in children.
糖尿病酮症酸中毒（DKA）是糖尿病患者，尤其是1型糖尿病（T1D）患者因胰岛素缺乏而发生的一种危及生命的急性代谢并发症。DKA患者中常可见中度高甘油三酯血症，但甘油三酯水平超过10g/L的严重高甘油三酯血症则鲜有报道。我们报告一例14岁男孩，患1型糖尿病4年，接受胰岛素治疗，同时患有肾上腺功能不全，接受氢化可的松治疗，该患者出现酮症酸中毒并伴有剧烈腹痛。检查发现甘油三酯水平为64g/L，脂肪酶水平为1000 U/L，腹部CT显示为E期胰腺炎。该患者接受了静脉胰岛素治疗、补液及非诺贝特治疗，临床和生物学指标均有良好改善。1型糖尿病中由严重高甘油三酯血症导致的胰腺炎是儿童DKA一种罕见但非常严重的并发症。
