Donelli Davide, Morini Lorenzo, Trenti Chiara, Santi Rosaria, Arioli Dimitriy, Negri Emanuele Alberto
Alta Intensità Medica, Department of Internal Medicine, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy.
Medicina II Cardiovascolare, Department of Internal Medicine, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy.
Eur J Case Rep Intern Med. 2018 May 25;5(5):000853. doi: 10.12890/2018_000853. eCollection 2018.
Diabetic ketoacidosis (DKA) can quite frequently present in association with acute pancreatitis (AP) caused by transient severe hypertriglyceridemia (HTG). Here we report the case of a patient presenting with DKA, severe HTG and AP who received urgent plasma exchange for HTG control, and who reached adequate serum triglyceride levels only after appropriate DKA management. The treatment of patients presenting with DKA and coexistent AP associated with severe HTG should focus first on appropriate DKA management. Plasma exchange as a treatment for severe HTG in patients with DKA and AP should be evaluated carefully.
The treatment of patients presenting with diabetic ketoacidosis, acute pancreatitis and severe hypertriglyceridemia should focus first on diabetic ketoacidosis management.Plasma exchange as a treatment for severe hypertriglyceridemia in patients with diabetic ketoacidosis and acute pancreatitis should be evaluated carefully.Triglyceride concentrations should always be measured in case of diabetic ketoacidosis.
糖尿病酮症酸中毒（DKA）常与由短暂性严重高甘油三酯血症（HTG）引起的急性胰腺炎（AP）相关。在此，我们报告一例患有DKA、严重HTG和AP的患者，该患者接受了紧急血浆置换以控制HTG，且仅在进行适当的DKA管理后才达到足够的血清甘油三酯水平。对于同时患有DKA和与严重HTG相关的AP的患者，治疗应首先着重于适当的DKA管理。对于DKA和AP患者，血浆置换作为严重HTG的一种治疗方法应谨慎评估。
对于患有糖尿病酮症酸中毒、急性胰腺炎和严重高甘油三酯血症的患者，治疗应首先着重于糖尿病酮症酸中毒的管理。对于糖尿病酮症酸中毒和急性胰腺炎患者，血浆置换作为严重高甘油三酯血症的一种治疗方法应谨慎评估。在糖尿病酮症酸中毒的情况下，应始终测量甘油三酯浓度。
