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急性胰腺炎作为非糖尿病患者糖尿病酮症酸中毒的罕见病因:基于病例的综述

Acute Pancreatitis as an Unusual Culprit of Diabetic Ketoacidosis in a Nondiabetic: A Case-Based Review.

作者信息

Imburgio Steven, Vedire Apurva, Sanekommu Harshavardhan, Johal Anmol, Taj Sobaan, Lesniak Christopher, Mushtaq Arman

机构信息

Jersey Shore University Medical Center, Department of Medicine, 1945 NJ-33, Neptune City, NJ 07753, USA.

Jersey Shore University Medical Center, Department of Endocrinology, 1945 NJ-33, Neptune City, NJ 07753, USA.

出版信息

Case Rep Endocrinol. 2023 Aug 22;2023:9122669. doi: 10.1155/2023/9122669. eCollection 2023.

Abstract

Acute pancreatitis has been associated with a multitude of complications including pancreatic necrosis, pseudocysts, abscesses, acute respiratory distress syndrome, disseminated intravascular coagulation, and hyperglycemia. To date, only rare case reports have demonstrated diabetic ketoacidosis (DKA) as a rare sequela of acute pancreatitis. We report a case of a 34-year-old female with no prior history of diabetes who was subsequently diagnosed with DKA after presenting with severe acute pancreatitis. This case serves as a framework to not only highlight DKA as a rare complication of acute pancreatitis but also to explore the potential pathophysiology that underlies this phenomenon including stress hyperglycemia and post-pancreatitis diabetes mellitus.

摘要

急性胰腺炎与多种并发症相关,包括胰腺坏死、假性囊肿、脓肿、急性呼吸窘迫综合征、弥散性血管内凝血和高血糖。迄今为止,仅有罕见的病例报告显示糖尿病酮症酸中毒(DKA)是急性胰腺炎的一种罕见后遗症。我们报告一例34岁女性病例,该患者既往无糖尿病史,在出现严重急性胰腺炎后被诊断为DKA。该病例不仅作为一个范例突出了DKA是急性胰腺炎的一种罕见并发症,还探讨了这一现象潜在的病理生理学机制,包括应激性高血糖和胰腺炎后糖尿病。

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Acute Pancreatitis: A Review.急性胰腺炎:综述。
JAMA. 2021 Jan 26;325(4):382-390. doi: 10.1001/jama.2020.20317.
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Acute pancreatitis and diabetes mellitus: a review.急性胰腺炎与糖尿病:综述。
Korean J Intern Med. 2021 Jan;36(1):15-24. doi: 10.3904/kjim.2020.505. Epub 2020 Dec 4.

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