Ahmad Soban, Yousaf Amman, Muhammad Shoaib, Ghaffar Fariha
Internal Medicine, East Carolina University, Greenville, North Carolina, USA.
Radiology, Hamad Medical Corporation, Doha, Qatar
BMJ Case Rep. 2021 Jun 15;14(6):e243534. doi: 10.1136/bcr-2021-243534.
Simultaneous occurrences of diabetic ketoacidosis (DKA) and thyroid storm have long been known, but only a few cases have been reported to date. Both these endocrine emergencies demand timely diagnosis and management to prevent adverse outcomes. Due to the similarities in their clinical presentation, DKA can mask the diagnosis of thyroid storm and vice versa. This case report describes a patient with Graves' disease who presented to the emergency department with nausea, vomiting and abdominal pain. He was found to have severe DKA without an explicit history of diabetes mellitus. Further evaluation revealed that the patient also had a concomitant thyroid storm that was the likely cause of his DKA. Early recognition and appropriate management of both conditions resulted in a favourable outcome. This paper emphasises that a simultaneous thyroid storm diagnosis should be considered in patients with DKA, especially those with a known history of thyroid disorders.
糖尿病酮症酸中毒（DKA）和甲状腺危象同时发生早已为人所知，但迄今为止仅有少数病例报道。这两种内分泌急症都需要及时诊断和处理以防止不良后果。由于它们临床表现相似，DKA可能掩盖甲状腺危象的诊断，反之亦然。本病例报告描述了一名患有格雷夫斯病的患者，他因恶心、呕吐和腹痛就诊于急诊科。发现他患有严重的DKA，但无明确的糖尿病病史。进一步评估发现该患者还同时患有甲状腺危象，这可能是其DKA的病因。对这两种情况的早期识别和恰当处理带来了良好的结果。本文强调，对于DKA患者，尤其是有甲状腺疾病已知病史的患者，应考虑同时诊断甲状腺危象。
