Vitelli Alessandra, Apuzzi Valentina, Calderaro Francesco, Fattoruso Olimpia, Bassi Vincenzo
U.O.C. Medicina Generale E Lungodegenza, San Giovanni Bosco, Asl Napoli 1 Centro, Naples, ITA.
U.O.C. Medicina Genereale E Lungodegenza, San Giovanni Bosco, Asl Napoli 1 Centro, Naples, ITA.
Cureus. 2020 May 26;12(5):e8299. doi: 10.7759/cureus.8299.
A 24-year-old obese Caucasian male, without relevant anamnesis, who was admitted to the ER presented with abdominal pain, nausea and vomiting, hyperglycemia, and diabetic ketoacidosis (DKA). The diagnosis of acute pancreatitis (AP) was supported by increased serum levels of triglycerides and lipase associated with abdominal CT scans. The patient was treated for five days with IV regular insulin, hydration, electrolytes replacement, and statin/fibrate therapy with clinical improvement. Some 10% hemoglobin A1c value, normal C-peptide level and negative glutamic acid decarboxylase (GAD-65), and islet cell autoantibodies suggested the diagnosis of a new-onset type 2 diabetes mellitus (DM) presenting with an uncommon triad of DKA and hypertriglyceridemia (HTG)-induced AP. Anamnestic history suggested that DKA was dependent on sugar-sweetened soft drinks abuse (soft drink ketosis), a clinical association more frequent in Asian than in Western patients.
一名24岁的肥胖白人男性，无相关既往史，因腹痛、恶心、呕吐、高血糖及糖尿病酮症酸中毒（DKA）入住急诊室。血清甘油三酯和脂肪酶水平升高以及腹部CT扫描结果支持急性胰腺炎（AP）的诊断。患者接受了为期五天的静脉注射正规胰岛素、补液、电解质补充治疗，以及他汀类/贝特类药物治疗，临床症状有所改善。糖化血红蛋白（HbA1c）值约为10%，C肽水平正常，谷氨酸脱羧酶（GAD - 65）及胰岛细胞自身抗体均为阴性，提示诊断为新发2型糖尿病（DM），伴有不常见的DKA和高甘油三酯血症（HTG）诱发的AP三联征。既往史提示DKA与滥用含糖软饮料有关（软饮料酮症），这种临床关联在亚洲患者中比西方患者更为常见。
