Severe hypertriglyceridemia in diabetic ketoacidosis accompanied by acute pancreatitis: case report

Abstract

We report a case of diabetic ketoacidosis (DKA) and hypertriglyceridemia (severely elevated to 15,240 mg/dL) complicated by acute pancreatitis, which was treated successfully with insulin therapy and conservative management. A 20-yr-old woman with a history of type 1 diabetes came to the emergency department 7 months after discontinuing insulin therapy. DKA, severe hypertriglyceridemia and acute pancreatitis were diagnosed, with DKA suspected of contributing to the development of the other conditions. In Korea, two cases of DKA-induced hypertriglyceridemia and 13 cases of hypertriglyceridemia-induced acute pancreatitis have been previously reported separately.

Keywords: Acute Pancreatitis; Diabetes Mellitus, Type 1; Diabetic Ketoacidosis; Hypertriglyceridemia.

Fig. 1

Photograph of hyperlipidemic serum extracted by centrifugation from the patient's blood sample.

Fig. 2

Contrast-enhanced pancreas CT scan (arterial phase). Initial pancreas CT scan shows diffuse swelling of pancreas body, tail, demonstrating CT grade D acute pancreatitis with peripancreatic fat infiltration (arrow), fluid collection suggesting inflammation (A) and edematous change of pancreatic head (openarrow) (B).