Sood Nikhil, Bansal Ojas, Garg Rohini, Hoskote Abhinav
Department of Hospital Medicine, Banner Health, Gilbert, AZ 85234, USA.
Department of Cardiology, Banner Health, Mesa, AZ 85202, USA.
JCEM Case Rep. 2024 Aug 30;2(9):luae156. doi: 10.1210/jcemcr/luae156. eCollection 2024 Sep.
Euglycemic ketoacidosis is a medical emergency characterized by euglycemia, metabolic acidosis, and ketonemia. It is a well-recognized adverse event in patients with diabetes taking sodium-glucose cotransporter-2 inhibitors. However, little has been reported about euglycemic ketoacidosis using glucagon-like peptide-1 (GLP-1) receptor agonists like semaglutide. We present a case of euglycemic ketoacidosis in a young female without diabetes who was taking semaglutide for weight loss for the last 7 months. She was treated with bicarbonate-containing dextrose infusion, which improved the ketoacidosis rapidly. The incidence of euglycemic ketoacidosis will likely increase with the increasing use of GLP-1 inhibitors, and recognizing the signs and symptoms of this life-threatening condition is essential to treat it effectively. Our literature search identified 1 reported case of euglycemic ketoacidosis in a patient without diabetes associated with tirzepatide but none with semaglutide.
正常血糖性酮症酸中毒是一种以血糖正常、代谢性酸中毒和酮血症为特征的医疗急症。它是服用钠-葡萄糖协同转运蛋白2抑制剂的糖尿病患者中一种广为人知的不良事件。然而，关于使用司美格鲁肽等胰高血糖素样肽-1（GLP-1）受体激动剂导致正常血糖性酮症酸中毒的报道很少。我们报告一例年轻非糖尿病女性发生正常血糖性酮症酸中毒的病例，该女性在过去7个月中一直在服用司美格鲁肽以减轻体重。她接受了含碳酸氢盐的葡萄糖输注治疗，酮症酸中毒迅速得到改善。随着GLP-1抑制剂使用的增加，正常血糖性酮症酸中毒的发生率可能会上升，认识到这种危及生命状况的体征和症状对于有效治疗至关重要。我们的文献检索发现1例非糖尿病患者使用替尔泊肽后发生正常血糖性酮症酸中毒的报道，但未发现与司美格鲁肽相关的病例。
