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Case Reports
. 2023 Sep 14;15(9):e45214.
doi: 10.7759/cureus.45214. eCollection 2023 Sep.

Diabetic Ketoacidosis-Induced "Terrible Triad" Associated With Seizures and Acute Renal Failure: A Report of a Rare Case

Shrenil Kavathia  1 , Sharvil Kataria  2 , Nirav Patel  3 , Sagar Patel  3
Affiliations
Case Reports

Diabetic Ketoacidosis-Induced "Terrible Triad" Associated With Seizures and Acute Renal Failure: A Report of a Rare Case

Shrenil Kavathia et al. Cureus. .

Abstract

We report a case of a 17-year-old male patient who came to the emergency department with abdominal pain, headaches for two days, lethargy, and Kussmaul breathing. Diabetic ketoacidosis (DKA) was diagnosed. The patient's clinical course was complicated with a severely elevated triglyceride (TG) level (25,585 mg/dL), acute pancreatitis, renal involvement, and generalized seizures. The proposed mechanism is triglyceride excess due to increased lipolysis, resulting in the formation of excess free fatty acids. The objective of this case report is to present and describe the clinical features, laboratory investigations, case management, and natural course of hypertriglyceridemia in DKA.

Keywords: acute pancreatitis; diabetes mellitus; diabetic ketoacidosis; hypertriglyceridemia; seizures; terrible triad of endocrinology.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Hyperlipidemic blood sample on the day of admission
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