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
Artigo
em Espanhol
| LILACS
| ID: lil-242707
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
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Índice:
LILACS (Américas)
Assunto principal:
Cetoacidose Diabética
/
Diabetes Mellitus
Tipo de estudo:
Estudo de etiologia
/
Fatores de risco
Limite:
Adulto
/
Feminino
/
Humanos
Idioma:
Espanhol
Revista:
Rev. méd. Chile
Assunto da revista:
Medicina
Ano de publicação:
1998
Tipo de documento:
Artigo
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