Diabetes mellitus descompensada y acidosis metabólica hiperclorémica: asociación de patologías en un caso / Association of hyperglycemia and hyperchloremic acidosis in a diabetic patient
Rev. méd. Chile
; 126(10): 1224-8, oct. 1998. tab
Article
in Es
| LILACS
| ID: lil-242707
Responsible library:
CL1.1
RESUMO
Diabetic ketoacidosis is manifested by elevated blood glucose levels, ketosis and metabolic acidosis with increased anion gap. A transitory hyperchloremic acidosis. with normal anion gap, can appear. We report a 21 years old female with a type 2 diabetes mellitus, admitted to the emergency room of a general hospital with hyperglycemia, absence of ketonemia, severe hypokalemia and hyperchloremic metabolic acidosis. Initially, she was diagnosed and treated as a severe diabetic ketoacidosis. Normal blood glucose levels were rapidly achieved but electrolyte and acid base alterations persisted, leading to the suspicion that another associated condition was causing the acidosis and hypokalemia. Urinary pH and anion gap measurement, the study of renal acidification and a bicarbonate overload test lead to the diagnosis of a distal renal tubular acidosis, secondary to a Sjögren syndrome, that was confirmed with a Schirmer test and positive anti Ro antibodies. In this diabetic patient, the acute hyperglycemia intensified the hypokalemia of her distal renal tubular acidosis and unchained the acute metabolic condition
Search on Google
Index:
LILACS
Main subject:
Diabetic Ketoacidosis
/
Diabetes Mellitus
Type of study:
Etiology_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
Language:
Es
Journal:
Rev. méd. Chile
Journal subject:
MEDICINA
Year:
1998
Type:
Article