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diabetic ketoacidosis diagnosis

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https://www.readbyqxmd.com/read/29218226/hamman-s-syndrome-in-diabetic-ketoacidosis
#1
Alexandra Rose Pain, Josh Pomroy, Andrea Benjamin
Hamman's syndrome (spontaneous subcutaneous emphysema and pneumomediastinum) is a rare complication of diabetic ketoacidosis (DKA), with a multifactorial etiology. Awareness of this syndrome is important: it is likely underdiagnosed as the main symptom of shortness of breath is often attributed to Kussmaul's breathing and the findings on chest radiograph can be subtle and easily missed. It is also important to be aware of and consider Boerhaave's syndrome as a differential diagnosis, a more serious condition with a 40% mortality rate when diagnosis is delayed...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29214049/latent-autoimmune-diabetes-of-adulthood-case-report
#2
Cristen P Page, Brian Fitzgerald, Emily M Hawes
Background: Primary care clinicians will see a higher incidence of type 2 diabetes in adult patients, and the diagnosis and management of an initial presentation of type 1 diabetes can pose challenges to clinicians who see it less frequently. Symptoms of hyperglycemia and risk of ketoacidosis may be missed. Further, endocrine autoimmune disease can run together in patients and families. Case presentation: A 49-year-old Caucasian female with history of pituitary adenoma and Graves' disease with history of thyroid ablation presented in the outpatient setting due to hand tingling of her right middle finger that was worse in the mornings and improved throughout the day...
2017: Clinical Diabetes and Endocrinology
https://www.readbyqxmd.com/read/29199115/frequency-and-phenotype-of-type-1-diabetes-in-the-first-six-decades-of-life-a-cross-sectional-genetically-stratified-survival-analysis-from-uk-biobank
#3
Nicholas J Thomas, Samuel E Jones, Michael N Weedon, Beverley M Shields, Richard A Oram, Andrew T Hattersley
BACKGROUND: Type 1 diabetes is typically considered a disease of children and young adults. Genetic susceptibility to young-onset type 1 diabetes is well defined and does not predispose to type 2 diabetes. It is not known how frequently genetic susceptibility to type 1 diabetes leads to a diagnosis of diabetes after age 30 years. We aimed to investigate the frequency and phenotype of type 1 diabetes resulting from high genetic susceptibility in the first six decades of life. METHODS: In this cross-sectional analysis, we used a type 1 diabetes genetic risk score based on 29 common variants to identify individuals of white European descent in UK Biobank in the half of the population with high or low genetic susceptibility to type 1 diabetes...
November 30, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29170817/postmortem-1h-mrs-detection-of-ketone-bodies-and-glucose-in-diabetic-ketoacidosis
#4
Jakob Heimer, Dominic Gascho, Vasiliki Chatzaraki, Damaris Fröhlich Knaute, Vera Sterzik, Rosa Maria Martinez, Michael J Thali, Niklaus Zoelch
Diabetic ketoacidosis (DKA) is a metabolic complication of diabetes mellitus that takes a lethal course if untreated. In this way relevant to forensic medicine, secure diagnosis of DKA usually involves the evidence of elevated levels of glucose and the ketone bodies acetone, acetoacetate, and β-hydroxybutyrate in corpse fluids. We conducted a postmortem hydrogen proton magnetic resonance spectroscopy (1H-MRS) in a case of lethal DKA. Distinctive resonances of all three ketone bodies as well as glucose were visible in spectra of cerebrospinal fluid, vitreous humor, and white matter...
November 23, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/29168157/perioperative-implications-of-sodium-glucose-cotransporter-2-inhibitors-a-case-series-of-euglycemic-diabetic-ketoacidosis-in-three-patients-after-cardiac-surgery
#5
Aaron Lau, Simon Bruce, Erica Wang, Ron Ree, Kevin Rondi, Anthony Chau
PURPOSE: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) comprise the newest class of oral hypoglycemic agents approved for treating type II diabetes mellitus (DM-II). Their use, however, has been associated with the rare development of euglycemic diabetic ketoacidosis (euDKA). We present three cases of euDKA that occurred following elective coronary artery bypass grafting surgery. The role of the anesthesiologist in the prevention, diagnosis, and management of this complication is also discussed...
November 22, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29165898/thrombocytopenia-associated-multi-organ-failure-secondary-to-hyperglycemic-hyperosmolar-non-ketotic-syndrome-a-case-report
#6
Naile Tufan-Pekkucuksen, Maria Carolina Gazzaneo, Natasha Susana Afonso, Sarah J Swartz, Joseph R Angelo, Poyyapakkam Srivaths
Thrombocytopenia associated multi-organ failure (TAMOF) is a clinical syndrome with features of new onset thrombocytopenia, increased lactate dehydrogenase, and multi-organ failure in critically ill patients. TAMOF can be the initial presentation of an underlying disease process or can develop during the course of illness either during the hospital stay. TAMOF has a high mortality rate if not treated; therefore, early detection is critical. TAMOF has been rarely reported in diabetic ketoacidosis. We are describing the first case of a patient diagnosed with hyperglycemic, hyperosmolar non-ketotic syndrome who developed TAMOF on the third day of his hospital course...
November 22, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/29157798/euglycemic-diabetic-ketoacidosis-secondary-to-dapagliflozin-use-a-case-report
#7
Felicity Brown, Tamara McColl
BACKGROUND: Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a novel class of oral antihyperglycemic agents. They are associated with rare cases of euglycemic diabetic ketoacidosis (DKA), which presents a diagnostic challenge in the emergency department (ED) and potentially severe consequences if missed. CASE REPORT: A 53-year-old man with type 2 diabetes mellitus and a recent Roux-en-Y gastric bypass surgery presented to the ED with nausea, vomiting, and generalized abdominal pain...
November 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29155695/citrobacter-endogenous-endophthalmitis-a-case-report-and-review-of-the-literature
#8
Daniel H T Wong, Candice C H Liu, Justin M K Tong, Wei-Kwang Luk, Kenneth K W Li
PURPOSE: We present a case of endogenous endophthalmitis because of an unusual bacterium, Citrobacter koseri. PATIENT: A 57-year-old woman without previous history of eye surgery or trauma presented with diabetic ketoacidosis and a painful right eye with the reduction of vision. C. koseri was identified in blood culture; thus, a diagnosis of right eye endogenous endophthalmitis was made. Intravenous and intravitreal antibiotics were both started, and vitreous culture further confirmed C...
November 16, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/29127768/diabetic-ketoacidosis-hyperuricemia-and-encephalopathy-intractable-to-regular-dose-insulin
#9
Jillian Gregory, Sonali Basu
BACKGROUND: Diabetic ketoacidosis (DKA) in children less than 1 year of age is a rare occurrence. Typical presentation includes a prodrome of weight loss and polyuria with subsequent presentation to medical care when acidosis becomes symptomatic. CASE PRESENTATION: We describe an unusual case of a previously healthy infant with a 3 days' history of constipation, presenting acutely with abdominal pain, lethargy, and dehydration. On initial evaluation, our patient had profound encephalopathy, with marked tachypnea and work of breathing...
November 11, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/29107759/the-unique-clinical-spectrum-of-maturity-onset-diabetes-of-the-young-type-3
#10
Yael Lebenthal, Naama Fisch Shvalb, Yael Gozlan, Ariel Tenenbaum, Yardena Tenenbaum-Rakover, Emmanuel Vaillant, Phillipe Froguel, Martine Vaxillaire, Galia Gat-Yablonski
Phenotypic variability in maturity-onset diabetes of the young (MODY) makes screening criteria for genomic analysis challenging. We describe the clinical spectrum in a large pedigree with HNF1A-MODY; as generations progressed, the course and outcome became poorer. Although uncommon, pancreatic autoantibodies and diabetes ketoacidosis should not exclude the diagnosis of MODY.
October 28, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29081625/sodium-glucose-transporter-2-inhibitors-and-diabetic-ketoacidosis-in-three-patients-with-diabetes-underlying-causation
#11
Jordan L Kelley, Matthew Strum, Daniel M Riche, Andrew M Chandler
Sodium glucose transporter 2 inhibitors (SGLT2i) inhibit the reabsorption of glucose in the renal tubules reducing glycemia and increasing glucosuria. The increased glucosuria causes a shift in normal flora and colonization of pathogenic microorganisms leading to an increase in mycotic genital infections. Recent Food and Drug Administration reported cases of diabetic ketoacidosis (DKA) after initiation of SGLT2i probes the question of safety with such agents. The mechanisms of ketoacidosis and the breakdown of lipids are often misunderstood, and blame is placed on lack of insulin or on medications used to treat diabetes...
July 2017: Journal of Pharmacology & Pharmacotherapeutics
https://www.readbyqxmd.com/read/29079259/endoscopic-endonasal-transsphenoidal-drainage-of-a-spontaneous-candida-glabrata-pituitary-abscess-case-report-intraoperative-video
#12
Ben A Strickland, Martin Pham, Joshua Bakhsheshian, John Carmichael, Martin Weiss, Gabriel Zada
Noniatrogenic pituitary abscesses remain a rare clinical entity, and are the indication for surgery in <1% of transsphenoidal approaches. Correct diagnosis of this rare entity is often delayed. Without timely treatment, morbidity and mortality are high. Of the 200 cases reported, less than half have identified a causative organism. We report the second case of a pituitary abscess caused by Candida species, and further provide intraoperative video of endoscopic management of this pathology. A 33-year-old woman presented with headache, hypopituitarism, and vision loss in the setting of diabetic ketoacidosis, and was found to have multiple abscesses in the liver, lung, kidney, and uterus...
October 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29073302/potential-clinical-benefits-of-a-two-bag-system-for-fluid-management-in-pediatric-intensive-care-unit-patients-with-diabetic-ketoacidosis
#13
Jacqueline P Velasco Md, Joshua Fogel PhD, Robert L Levine Md PhD, Peter Ciminera Md, David Fagan Md, Renee Bargman Md
INTRODUCTION: Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus (DM) that requires appropriate treatment with insulin and intravenous fluids. Both one-bag and two-bag systems of fluid management are used to treat pediatric diabetic ketoacidosis. AIM OF THE STUDY: We compare the one-bag and two-bag systems of fluid managementwith regard to incidence of hypoglycemia, serum bicarbonate correction, pH correction and discharge from the pediatric intensive care unit (PICU)...
2017: Pediatric Endocrinology, Diabetes, and Metabolism
https://www.readbyqxmd.com/read/29037929/severe-sepsis-and-acute-myocardial-dysfunction-in-an-adolescent-with-chlamydia-trachomatis-pelvic-inflammatory-disease-a-case-report
#14
Ashley M Morgan, R Claire Roden, Steven C Matson, Grant M Wallace, Hannah L H Lange, Andrea E Bonny
BACKGROUND: Although generally asymptomatic, severe Chlamydia trachomatis (C. trachomatis) infections have been documented. C. trachomatis has been associated with both myocarditis and sepsis. CASE: A 19-year-old female with type 1 diabetes mellitus developed sudden-onset mental status change and shock after resolution of diabetic ketoacidosis. Abdominal and pelvic imaging demonstrated uterine and adnexal inflammation, and pelvic exam confirmed a diagnosis of pelvic inflammatory disease...
October 13, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/29028140/report-of-12-cases-with-tracheobronchial-mucormycosis-and-a-review
#15
Ruoxi He, Chengping Hu, Yongjun Tang, Huaping Yang, Liming Cao, Ruichao Niu
OBJECTIVES: Tranchobronchial mucormycosis is a rare and invasive pulmonary mucormycosis involving the tracheobronchial tree. DATA SOURCE: at a 3500-bed tertiary care center. STUDY SELECTION: This was a retroactive study of 12 cases of tranchobronchial mucormycosis diagnosed in our hospital, and 48 cases that were previously reported in the English literature. RESULTS: Rhizopus was the predominant species of pathogen (66...
October 13, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29026710/factors-associated-with-c-peptide-levels-after-diagnosis-in-children-with-type-1-diabetes-mellitus
#16
Jung Won Hwang, Min Sun Kim, Dae-Yeol Lee
C-peptide is the best indicator of endogenous insulin secretion in patients with diabetes. This study investigated the relationship between C-peptide levels and clinical/laboratory parameters of children with type 1 diabetes mellitus (T1DM), as measured at 6-month intervals after diagnosis. We retrospectively reviewed the data of 34 children with newly diagnosed T1DM. The study subjects were subdivided into a rapid progression group with C-peptide levels <0.6 ng/mL at 36 months (n=27; Group A) and a slow progression group with C-peptide levels >0...
September 2017: Chonnam Medical Journal
https://www.readbyqxmd.com/read/29026609/ketosis-prone-diabetes-and-sle-co-presenting-in-an-african-lady-with-previous-gestational-diabetes
#17
S Hussain, S Keat, S V Gelding
We describe the case of an African woman who was diagnosed with ketosis-prone diabetes with diabetes-associated autoantibodies, after being admitted for diabetic ketoacidosis (DKA) precipitated by her first presentation of systemic lupus erythematosus (SLE). She had a seven-year history of recurrent gestational diabetes (GDM) not requiring insulin therapy, with return to normoglycaemia after each pregnancy. This might have suggested that she had now developed type 2 diabetes (T2D). However, the diagnosis of SLE prompted testing for an autoimmune aetiology for the diabetes, and she was found to have a very high titre of GAD antibodies...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28989879/root-cause-analysis-of-diabetic-ketoacidosis-admissions-at-a-tertiary-referral-pediatric-emergency-department-in-north-india
#18
Muralidharan Jayashree, Rohit Sasidharan, Sunit Singhi, Karthi Nallasamy, Mullai Baalaaji
OBJECTIVES: To identify system-based factors contributing to Emergency Department (ED) admissions of children with diabetic ketoacidosis (DKA) and related complications with emphasis on parental and physician awareness and prereferral management. MATERIALS AND METHODS: A prospective observational root cause analysis study of all consecutive admissions of children with DKA to pediatric ED of a tertiary care referral hospital in northern India over a period of 1 year (July 2010-June 2011)...
September 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28989569/clinical-profile-of-diabetes-at-diagnosis-among-children-and-adolescents-at-an-endocrine-clinic-in-ghana
#19
Emmanuel Ameyaw, Serwah B Asafo-Agyei, Sumithira Thavapalan, Angela C Middlehurst, Graham D Ogle
AIM: To determine the clinical features of diabetes in children and adolescents in Ghana. METHODS: Retrospective review of clinical features of all children and adolescents with new-onset diabetes seen at the paediatric endocrinology clinic of Komfo Anokye Teaching Hospital in Kumasi, from February 2012 to Auguest 2016. RESULTS: One hundred and six subjects presented with diabetes. Ninety (84.9%) were diagnosed by clinical features and family history as type 1, and 16 (15...
September 15, 2017: World Journal of Diabetes
https://www.readbyqxmd.com/read/28984788/concurrent-diabetic-ketoacidosis-in-hypertriglyceridemia-induced-pancreatitis-how-does-it-affect-the-clinical-course-and-severity-scores
#20
Yuchen Wang, Bashar M Attar, Keiki Hinami, Palashkumar Jaiswal, John Erikson Yap, Radhika Jaiswal, Kalpit Devani, Carlos Roberto Simons-Linares, Melchor V Demetria
OBJECTIVES: Concurrent diabetic ketoacidosis (DKA) is highly prevalent in patients with hypertriglyceridemia-induced pancreatitis (HP). Diabetic ketoacidosis could potentially complicate the diagnosis, management, and prognosis of HP. This study aimed to directly compare the clinical course of HP with and without DKA and assess the outcomes of frequently used severity-prediction scores in such population. METHODS: We retrospectively analyzed 140 patients with HP; 37 patients (26...
November 2017: Pancreas
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