Shrestha Ankit, Bam Prabin Kumar, Pandit Aakash, Shrestha Hari, Koirala Melisha
Department of Internal Medicine Chitwan Medical College Bharatpur Nepal.
Clin Case Rep. 2024 May 22;12(6):e8926. doi: 10.1002/ccr3.8926. eCollection 2024 Jun.
Managing diabetic ketoacidosis (DKA) in individuals with severe dyslipidemia necessitates a comprehensive approach. While rehydration and continuous insulin infusion are fundamental components of DKA management due to the underlying insulin deficiency, the presence of severe hyperlipidemia with eruptive xanthomas warrants additional consideration. Early initiation of lipid-lowering agents can expedite the resolution of cutaneous lesions and substantially mitigate the risk of severe complications such as pancreatitis, along with attenuating long-term cardiovascular risks.
Xanthomas are the benign lesions which are generated by localized lipid deposits in the skin, tendons, and subcutaneous tissue. They appear clinically as yellowish papules, nodules, or plaques. Acute pancreatitis and eruptive xanthomas can occur as complications of hyperlipidemia. Uncontrolled diabetes mellitus in one of the risk factors for hypertriglyceridemia. Early recognition and treatment of the eruptive xanthomatosis as a warning sign of hypertriglyceridemia can decrease the morbidity and mortality due to acute pancreatitis. Here, we discuss a case of 37-years old female patient with uncontrolled type II diabetes mellitus presented with acute pancreatitis and eruptive xanthomas as result of raised triglycerides and uncontrolled diabetes.
对于患有严重血脂异常的个体，管理糖尿病酮症酸中毒（DKA）需要采取综合方法。由于潜在的胰岛素缺乏，补液和持续胰岛素输注是DKA管理的基本组成部分，但伴有发疹性黄瘤的严重高脂血症需要额外考虑。早期启动降脂药物可以加快皮肤病变的消退，并大幅降低胰腺炎等严重并发症的风险，同时减轻长期心血管风险。
黄瘤是由皮肤、肌腱和皮下组织中的局部脂质沉积产生的良性病变。它们在临床上表现为淡黄色丘疹、结节或斑块。急性胰腺炎和发疹性黄瘤可作为高脂血症的并发症出现。未控制的糖尿病是高甘油三酯血症的危险因素之一。早期识别和治疗作为高甘油三酯血症警示信号的发疹性黄瘤病可降低急性胰腺炎导致的发病率和死亡率。在此，我们讨论一例37岁女性患者，她患有未控制的II型糖尿病，因甘油三酯升高和糖尿病未控制而出现急性胰腺炎和发疹性黄瘤。
