Ahmed Shahamah, Hassan Mushhuda, Rochlani Hemali, Shah Krushi
Department of Internal Medicine, Montefiore Medical Centre, Bronx, NY 10466, USA.
JCEM Case Rep. 2025 Mar 21;3(4):luaf065. doi: 10.1210/jcemcr/luaf065. eCollection 2025 Apr.
This is a case of an older man with no prior history of diabetes presenting with a combination of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) in the setting of new-onset diabetes mellitus. His further work-up revealed intraductal papillary mucinous neoplasm (IPMN) on pancreatic imaging. Though his diabetes etiology could be multifactorial, it is possible that it is an initial presentation of IPMN. Data have been suggestive of diabetes mellitus associated with degree of dysplasia and worse prognosis of IPMN but the exact pathophysiology behind this is unknown, and it is unclear whether diabetes mellitus is an early presentation of IPMN. We discuss possible differential diagnoses needed to evaluate patients for possible triggers behind DKA and etiologies behind new-onset diabetes mellitus when indicated.
这是一例老年男性患者，既往无糖尿病病史，在新发糖尿病的情况下同时出现糖尿病酮症酸中毒（DKA）和高渗高血糖状态（HHS）。其进一步检查发现胰腺影像学显示导管内乳头状黏液性肿瘤（IPMN）。尽管他的糖尿病病因可能是多因素的，但有可能是IPMN的首发表现。有数据提示糖尿病与IPMN的发育异常程度及更差的预后相关，但这背后的确切病理生理机制尚不清楚，且糖尿病是否为IPMN的早期表现也不明确。我们讨论了在有指征时评估患者DKA潜在触发因素及新发糖尿病病因所需的可能鉴别诊断。
